Provider Demographics
NPI:1033141312
Name:CHASE, ELIZABETH C (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:C
Last Name:CHASE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-3437
Mailing Address - Country:US
Mailing Address - Phone:603-742-0101
Mailing Address - Fax:603-743-3171
Practice Address - Street 1:770 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-3437
Practice Address - Country:US
Practice Address - Phone:603-742-0101
Practice Address - Fax:603-743-3171
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH10858207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH01Y002452NH01OtherANTHEM
NH3076393Medicaid
NH01Y002452NH01OtherANTHEM
G56131Medicare UPIN