Individual
PAUL D LIDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
29 MAPLE ST, LITTLETON, NH 03561-4729
(603) 444-5358
Mailing address
87 WASHINGTON ST, CONWAY, NH 03818-6044
(603) 447-3347
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
7653
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0108024T0NH02
ANTHEM FEP
NH
01
—
0108024Y0NH02
ANTHEM
NH
Enumeration date
03/15/2007
Last updated
06/09/2008
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