Provider Demographics
NPI:1508813122
Name:INDORF, GERALD S (MD)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:S
Last Name:INDORF
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:87 MCGREGOR ST
Mailing Address - Street 2:STE 1300
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-3765
Mailing Address - Country:US
Mailing Address - Phone:603-695-2500
Mailing Address - Fax:603-695-2960
Practice Address - Street 1:87 MCGREGOR ST
Practice Address - Street 2:STE 1300
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-3765
Practice Address - Country:US
Practice Address - Phone:603-695-2500
Practice Address - Fax:603-695-2960
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2011-07-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH64092084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30002813Medicaid
NH30002813Medicaid
NHNH941301Medicare PIN