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
100 ROBIE ROAD, BRISTOL, NH 03222-4506
(603) 744-6200
(603) 744-9024
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
Primary
—
—
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
—
3117469
—
NH
Enumeration date
06/04/2008
Last updated
07/27/2021
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