| |
411 Us Route 4 Enfield NH 03748-3168 | |
(603) 632-5600 | |
(603) 632-5477 |
Full Name | |
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Speciality | Family Medicine |
Location | 411 Us Route 4, Enfield, New Hampshire |
Authorized Official Name and Position | David W Beaufait (OWNER) |
Authorized Official Contact | 6036325600 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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411 Us Route 4 Po Box 669 Enfield NH 03748-3168 Ph: (603) 632-5600 | 411 Us Route 4 Enfield NH 03748-3168 Ph: (603) 632-5600 |
NPI Number | 1124344999 |
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Provider Enumeration Date | 04/19/2010 |
Last Update Date | 06/28/2010 |
Medicare PECOS PAC ID | 9931231347 |
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Medicare Enrollment ID | O20100721000364 |
Identifier | Type | State | Issuer |
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1124344999 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | 6754 (New Hampshire) | Primary |
Provider Name | David W Beaufait |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1396861985 PECOS PAC ID: 3678501806 Enrollment ID: I20050729000378 |