Provider Demographics
NPI:1629041314
Name:TODD, WILLIAM MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MICHAEL
Last Name:TODD
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 1:400 GREAT BAY RD
Mailing Address - Street 2:
Mailing Address - City:GREENLAND
Mailing Address - State:NH
Mailing Address - Zip Code:03840-2161
Mailing Address - Country:US
Mailing Address - Phone:603-431-6045
Mailing Address - Fax:
Practice Address - Street 1:100 MCGREGOR ST
Practice Address - Street 2:CATHOLIC MEDICAL CENTER
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-3730
Practice Address - Country:US
Practice Address - Phone:603-663-6478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-11
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH12360207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME142910000Medicaid
MA2130726Medicaid
AA79991OtherHARVARD PILGRIM
NH01Y007667NH03OtherANTHEM
NH01Y007667NH02OtherANTHEM
4138008OtherMVP
NH30206504Medicaid
P00384960OtherRAILROAD MEDICARE
000000038818OtherBMC HEALTHNET PLAN
AA79991OtherHARVARD PILGRIM
000000038818OtherBMC HEALTHNET PLAN
NHRE8001Medicare PIN