Provider Demographics
NPI:1518914209
Name:STOCK, MARJORIE K (MD)
Entity Type:Individual
Prefix:DR
First Name:MARJORIE
Middle Name:K
Last Name:STOCK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:130 TARRYTOWN RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-2713
Mailing Address - Country:US
Mailing Address - Phone:603-669-0831
Mailing Address - Fax:603-669-0477
Practice Address - Street 1:166 KINSLEY ST STE 302
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3676
Practice Address - Country:US
Practice Address - Phone:603-595-4800
Practice Address - Fax:603-598-8307
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA77163207Y00000X
NH9663207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHF54266Medicare UPIN
NHSTRE4015Medicare PIN
NHF54266Medicare UPIN