Individual
DR. ILDA MARCELA BETANCUR RESTREPO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
173 DANIEL WEBSTER HWY, NASHUA, NH 03060-5224
(603) 891-4400
Mailing address
C/O ST MARY'S HEALTH SYSTEM - PROVIDER ENROLLMENT, PO BOX 7291, LEWISTON, ME 04243-7291
(207) 777-8695
(207) 777-8800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16659
NH
207R00000X
Internal Medicine Physician
MT196087
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3098279
—
NH
Enumeration date
07/12/2009
Last updated
11/23/2020
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