Provider Demographics
NPI:1235196940
Name:HEDBERG, VIKING A (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:VIKING
Middle Name:A
Last Name:HEDBERG
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-7559
Mailing Address - Country:US
Mailing Address - Phone:603-228-7200
Mailing Address - Fax:603-227-7562
Practice Address - Street 1:250 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-7559
Practice Address - Country:US
Practice Address - Phone:603-228-7200
Practice Address - Fax:603-227-7562
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH99902080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30010443Medicaid
VT0RE4460Medicaid
NHRE4460Medicare PIN
F13099Medicare UPIN