Individual
IVAR LESLIE FRITHSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
580 COURT ST, KEENE, NH 03431-1718
(603) 354-5454
Mailing address
580 COURT ST, KEENE, NH 03431-1718
(603) 354-5454
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25940
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
259400
—
SC
05
—
32001211
—
NH
Enumeration date
08/29/2006
Last updated
04/18/2012
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