Individual
DR. BEVERLY J ENTWISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
250 PLEASANT STREET, YEAPLE BUILDING, CONCORD, NH 03301
(603) 228-7200
(603) 228-7307
Mailing address
250 PLEASANT STREET, YEAPLE BUILDING, CONCORD, NH 03301
(603) 228-7200
(603) 228-7307
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
7945
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25526
CIGNA ID#
NH
05
—
30002613
—
NH
01
—
3016717
AETNA ID#
NH
01
—
371528
MVP ID#
NH
01
—
E14790
HARVARD PILGRIM ID#
NH
01
—
H005016
TRICARE ID#
NH
Enumeration date
05/31/2005
Last updated
10/24/2007
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