David W Beaufait, M.D.

Individual provider Active NPI Family Medicine Physician · Enfield, NH

NPI 1396861985 · NPPES record last updated Oct 29, 2019

Key facts

NPI
1396861985
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
6754 (NH)
Practice address
411 U.S. Route 4
Enfield, NH 03748
Phone
(603) 632-5600
Fax
(603) 632-5477
NPI assigned
Mar 22, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20988NHMDFamily Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 6754 NH Yes

Addresses

Primary practice location

411 U.S. Route 4
Enfield, NH 03748

Mailing address

252 Mechanic St
Lebanon, NH 03766-2613
Phone (603) 632-5600

Other identifiers

IdentifierTypeStateIssuer
743054927OtherVTVERMONT BLUE SHIELD
0105271YPNH01OtherNHBLUE SHIELD
81080107MedicaidNH

Other providers in Enfield, NH

All providers in Enfield, NH · Family Medicine Physician in New Hampshire

Sources for this page

Verify at the official NPI Registry.