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Individual

DR. ERIC S LANDIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
703 RIVERWAY PL, BEDFORD, NH 03110-6768
(603) 668-7096
(603) 669-6944
Mailing address
703 RIVERWAY PL, BEDFORD, NH 03110-6768
(603) 668-7096
(603) 669-6944

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
8990
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
008990
TUFTS
NH
01
0109229Y0 NH06
ANTHEM MCH TAX ID
NH
01
0109229Y0NH03
BLUE CROSS
NH
01
2200875
AETNA
NH
01
2788
CIGNA
NH
05
30006019
NH
01
300064319
RAILROAD MEDICARE
NH
Enumeration date
04/17/2006
Last updated
07/08/2007
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