Provider Demographics
NPI:1003835216
Name:CAPITAL REGION PHYSICIANS GROUP
Entity Type:Organization
Organization Name:CAPITAL REGION PHYSICIANS GROUP
Other - Org Name:CONCORD OBSTETRICS AND GYNECOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO/SENIOR VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:R
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-227-7000
Mailing Address - Street 1:189 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5046
Mailing Address - Country:US
Mailing Address - Phone:603-228-1111
Mailing Address - Fax:603-226-4314
Practice Address - Street 1:189 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5046
Practice Address - Country:US
Practice Address - Phone:603-228-1111
Practice Address - Fax:603-226-4314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE8130Medicare PIN