Provider Demographics
NPI:1700823077
Name:IMGRUND, STEPHEN P (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:P
Last Name:IMGRUND
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:246 PLEASANT STREET MEMORIAL BUILDING, WEST, GROUND FLO
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2588
Mailing Address - Country:US
Mailing Address - Phone:603-224-9661
Mailing Address - Fax:603-228-7051
Practice Address - Street 1:250 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-7539
Practice Address - Country:US
Practice Address - Phone:603-224-9661
Practice Address - Fax:603-228-7051
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2020-07-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH7052207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHB85964Medicare UPIN