Provider Demographics
NPI:1790787323
Name:BARLOW, PAUL
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:BARLOW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HIGHLANDER WAY STE 4
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-7404
Mailing Address - Country:US
Mailing Address - Phone:603-314-7565
Mailing Address - Fax:603-314-7567
Practice Address - Street 1:1 HIGHLANDER WAY STE 4
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-7404
Practice Address - Country:US
Practice Address - Phone:603-314-7565
Practice Address - Fax:603-314-7567
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0517363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH00000000Medicaid
NH00000000Medicaid
0000000000Medicare ID - Type UnspecifiedNO NUMBER