Organization
MID-STATE HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT MACLEOD (CEO)
(603) 536-4000
Entity
Organization
Contact information
Practice address
101 BOULDER POINT DR, SUITE 1, PLYMOUTH, NH 03264-3170
(603) 536-4000
(603) 536-4001
Mailing address
101 BOULDER POINT DR, SUITE 1, PLYMOUTH, NH 03264-3170
(603) 536-4000
(603) 536-4001
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30009302
—
NH
01
—
301817
MEDICARE PART A PLYMOUTH
NH
01
—
301818
MEDICARE PART A BRISTOL
NH
05
—
3073404
—
NH
Enumeration date
06/09/2008
Last updated
06/17/2025
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