Individual
DR. JOHN FREDERIC MODLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
(603) 653-6041
(603) 653-6050
Mailing address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
(603) 653-6041
Taxonomy
Speciality
Code
Description
License number
State
2080P0208X
Pediatric Infectious Diseases Physician
Primary
8561
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001647
—
VT
05
—
80001647
—
NH
Enumeration date
08/22/2006
Last updated
07/19/2011
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