Provider Demographics
NPI:1437129624
Name:BEAUBOEUF, ANDRE F (MD)
Entity Type:Individual
Prefix:
First Name:ANDRE
Middle Name:F
Last Name:BEAUBOEUF
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:PO BOX 160
Mailing Address - Street 2:PATIENT FINANCIAL SERVICES
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561
Mailing Address - Country:US
Mailing Address - Phone:603-259-7627
Mailing Address - Fax:603-259-7561
Practice Address - Street 1:600 ST. JOHNSBURY RD.
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:NH
Practice Address - Zip Code:03561
Practice Address - Country:US
Practice Address - Phone:603-444-9000
Practice Address - Fax:603-527-2984
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11345207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH01Y003351NH01OtherANTHEM
NH45050OtherHARVARD PILGRIM HEALTHCAR
NH30201692Medicaid
NH4126673OtherMVP
NH8983987OtherCIGNA
NH30201692Medicaid
NH4126673OtherMVP