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Individual

BENJAMIN R NORDSTROM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD, PHD

Contact information

Practice address
1 MEDICAL CENTER DRIVE, LEBANON, NH 03756
(603) 650-5574
Mailing address
1 MEDICAL CENTER DRIVE, LEBANON, NH 03756
(603) 650-5574

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
226027
NY
2084P0800X
Psychiatry Physician
Primary
MD432801
PA
2084P0802X
Addiction Psychiatry Physician
226027
NY
2084P0802X
Addiction Psychiatry Physician
MD432801
PA

Other

Enumeration date
02/24/2007
Last updated
01/05/2012
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