Individual
MATTHEW ROBERT LEBOEUF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18 OLD ETNA RD, LEBANON, NH 03766
(603) 650-3100
Mailing address
1 MEDICAL CENTER DR, LEBANON, NH 03756-0001
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
18976
NH
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
18976
NH
207R00000X
Internal Medicine Physician
MT204771
PA
390200000X
Student in an Organized Health Care Education/Training Program
MT204771
PA
Other
Enumeration date
06/03/2013
Last updated
04/28/2021
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