Provider Demographics
NPI:1114099702
Name:RUPP HODGE, IRENE PATTERSON (MD)
Entity Type:Individual
Prefix:DR
First Name:IRENE
Middle Name:PATTERSON
Last Name:RUPP HODGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:21 WHITEHALL RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-3236
Mailing Address - Country:US
Mailing Address - Phone:603-335-8866
Mailing Address - Fax:603-335-2038
Practice Address - Street 1:21 WHITEHALL RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-3236
Practice Address - Country:US
Practice Address - Phone:603-335-8866
Practice Address - Fax:603-335-2038
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH9662207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30213663Medicaid
NHRE8345Medicare ID - Type Unspecified
NHG56284Medicare UPIN