Individual
YULIUS LEONARD HARYADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10 MEMBERS WAY FL 5, DOVER, NH 03820-5933
(603) 609-6800
(603) 609-6820
Mailing address
789 CENTRAL AVE, DOVER, NH 03820-2526
(603) 609-6800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20209
NH
208M00000X
Hospitalist Physician
20209
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3123048
—
NH
Enumeration date
07/05/2017
Last updated
09/14/2020
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