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Individual

DR. SUZANNE C BOULTER

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
250 PLEASANT ST., YEAPLE BUILDING, CONCORD, NH 03301-7539
(603) 228-7200
(603) 228-7307
Mailing address
250 PLEASANT ST., YEAPLE BUILDING, CONCORD, NH 03301-7539
(603) 228-7200
(603) 228-7307

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4811
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2553
CIGNA
NH
01
3016636
AETNA
NH
05
361
NH
01
371516
MVP HEALTHCARE
NH
01
D78744
HARVARD PILGRIM HEALTHCAR
NH
01
H005016
TRICARE
NH
Enumeration date
06/16/2005
Last updated
07/08/2007
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