Organization
LONDONDERRY GASTROENTEROLOGY ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK KENNETH DETWEILER M.D. (PHYSICIAN)
(603) 818-4712
Entity
Organization
Contact information
Practice address
1B COMMONS DR, UNIT 9A, LONDONDERRY, NH 03053-3441
(603) 818-4712
(603) 421-6899
Mailing address
1 COMMONS DR # B, UNIT 9A, LONDONDERRY, NH 03053-3441
(603) 818-4712
(603) 421-6899
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
6919
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
80001279
—
NH
Enumeration date
07/15/2006
Last updated
10/19/2015
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