Individual
DR. HORACE FULLER HENRIQUES III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
(603) 650-8113
(603) 650-8030
Mailing address
74 PLEASANT ST, STE 204, NEW LONDON, NH 03257-5881
(603) 650-8113
(603) 650-8030
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
8675
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0002054
—
VT
05
—
80002054
—
NH
Enumeration date
07/12/2006
Last updated
01/10/2017
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