Organization
BEDFORD PEDIATRICS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KERMIT BRUNELLE M.D. (PRESIDENT)
(603) 471-0831
Entity
Organization
Contact information
Practice address
360 ROUTE 101, UNIT 7B, BEDFORD, NH 03110-5030
(603) 471-0831
(603) 471-0890
Mailing address
360 ROUTE 101, UNIT 7B, BEDFORD, NH 03110-5030
(603) 471-0831
(603) 471-0890
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30210849
—
NH
Enumeration date
03/22/2007
Last updated
08/22/2020
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