Provider Demographics
NPI:1497709448
Name:PACE, MARK V (DO)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:V
Last Name:PACE
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:31 STILES RD
Mailing Address - Street 2:SUITE 2100
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-2897
Mailing Address - Country:US
Mailing Address - Phone:603-894-0500
Mailing Address - Fax:603-894-0535
Practice Address - Street 1:31 STILES RD
Practice Address - Street 2:SUITE 2100
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2897
Practice Address - Country:US
Practice Address - Phone:603-894-0500
Practice Address - Fax:603-894-0535
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2017-02-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH16019207Q00000X
NC200401555207Q00000X
NC02466207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3081881Medicaid
E02341Medicare UPIN
NHRAILROAD P01224883Medicare PIN
NH002029902Medicare PIN
NC138FOOtherBCBS
NC2402299Medicare PIN
NH3080881Medicaid