Provider Demographics
NPI:1275550352
Name:MAHUTTE, NEAL GREGORY (MD)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:GREGORY
Last Name:MAHUTTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 SUNSET ROCK RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03766-2007
Mailing Address - Country:US
Mailing Address - Phone:603-448-9815
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-1000
Practice Address - Country:US
Practice Address - Phone:603-653-9240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH12001207VE0102X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Not Answered207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30203639Medicaid
VT1009835Medicaid
VT1009835Medicaid
NHRE7272Medicare ID - Type Unspecified