| Dr Suls Family & Sports Medicine | |
|
20 Washington Pl Ste 3 Bedford NH 03110-6743 | |
| (603) 622-2112 | |
| (603) 624-1570 |
| Full Name | Dr Suls Family & Sports Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 20 Washington Pl Ste 3, Bedford, New Hampshire |
| Authorized Official Name and Position | Howard Lee Suls (OWNER) |
| Authorized Official Contact | 6036222112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Suls Family & Sports Medicine 20 Washington Pl Ste 3 Bedford NH 03110-6743 Ph: (603) 622-2112 | Dr Suls Family & Sports Medicine 20 Washington Pl Ste 3 Bedford NH 03110-6743 Ph: (603) 622-2112 |
| NPI Number | 1851396006 |
|---|---|
| Provider Enumeration Date | 06/15/2005 |
| Last Update Date | 06/27/2019 |
| Medicare PECOS PAC ID | 5092796789 |
|---|---|
| Medicare Enrollment ID | O20040527001221 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851396006 | NPI | - | NPPES |
| 55970 | Other | NH | CIGNS VENDER # |
| CK3214 | Other | NH | RR MEDICARE |
| 2567744 | Other | NH | OXFORD |
| 30211159 | Medicaid | NH | |
| M17742 | Other | NH | BCBS OF MASSACHUSETTS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 9753 (New Hampshire) | Primary |
| 2081S0010X | Physical Medicine & Rehabilitation - Sports Medicine | 9753 (New Hampshire) | Secondary |
| Provider Name | Howard L Suls |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336144682 PECOS PAC ID: 9234110925 Enrollment ID: I20050622001114 |
| Provider Name | Charlotte Phaneuf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770928582 PECOS PAC ID: 5597999813 Enrollment ID: I20130927000590 |
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