Individual
MARK LEO TIMMERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
454 DANIEL WEBSTER HWY, MERRIMACK, NH 03054-3699
(603) 424-8120
(603) 424-8140
Mailing address
454 DANIEL WEBSTER HWY, MERRIMACK, NH 03054-3695
(603) 424-8120
(603) 424-8140
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
NH 7663
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0103422YPNH01
BC/BS INDIVIDUAL NUMBER
NH
01
—
140824540
BC/BS MASS BILLING #
MA
01
—
30D0084963
CLIA NUMBER
NH
01
—
50Y095600NH01
BC/BS NH GROUP NUMBER
NH
01
—
B86207
HPHC BILLING NUMBER
NH
01
—
NH 7663
NH STATE LICENSE
NH
Enumeration date
07/24/2006
Last updated
03/07/2023
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