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Individual

DA H LE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 PARKLAND DR, DERRY, NH 03038-2746
(603) 421-2220
(603) 421-2223
Mailing address
1 PARKLAND DR, DERRY, NH 03038-2746
(603) 421-2220
(603) 421-2223

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
11569
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01Y004212NH02
ANTHEM
NH
01
01Y004212NH03
ANTHEM
NH
05
2092671
MA
05
30202078
NH
01
436772
HARVARD PILGRIM
01
626159
HARVARD PILGRIM
01
7036649
AETNA
NH
01
P00200157
RAILROAD MEDICARE
Enumeration date
07/12/2006
Last updated
05/05/2008
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