Individual
DR. MICHAEL R JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
65 CALEF HWY STE 200, LEE, NH 03861-6703
(603) 868-3300
Mailing address
PO BOX 412503, BOSTON, MA 02241-2503
(617) 726-3884
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17702
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3105073
—
NH
Enumeration date
05/01/2013
Last updated
03/16/2021
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