Provider Demographics
NPI:1164864658
Name:ALDRIDGE, MAUDE (MD)
Entity Type:Individual
Prefix:DR
First Name:MAUDE
Middle Name:
Last Name:ALDRIDGE
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:PO BOX 1327
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03247-1327
Mailing Address - Country:US
Mailing Address - Phone:603-524-3211
Mailing Address - Fax:
Practice Address - Street 1:8 CORPORATE DR
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NH
Practice Address - Zip Code:03220-3103
Practice Address - Country:US
Practice Address - Phone:603-528-0995
Practice Address - Fax:603-528-0996
Is Sole Proprietor?:No
Enumeration Date:2013-07-24
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH18092208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3109844Medicaid