Individual
JESSICA B WALLAERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 MEDICAL CENTER DR, DHMC, LEBANON, NH 03756-0001
(603) 650-8193
Mailing address
1 MEDICAL CENTER DR, DHMC, LEBANON, NH 03756-0001
(603) 650-8193
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
15096
NH
2086S0129X
Vascular Surgery Physician
Primary
15096
NH
Other
Enumeration date
04/29/2008
Last updated
07/12/2021
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