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Individual

MARK R HENSCHKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
2064 WOODBURY AVE, SUITE 102, NEWINGTON, NH 03801-7801
(603) 766-8130
(603) 766-8131
Mailing address
2064 WOODBURY AVE, SUITE 102, NEWINGTON, NH 03801-7801
(603) 766-8130
(603) 766-8131

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9158
NH
207R00000X
Internal Medicine Physician
DO13001
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020470410
TAX ID
NH
05
30006683
NH
01
P00004229
RAILROAD MEDICARE
NH
Enumeration date
09/08/2005
Last updated
09/26/2013
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