Provider Demographics
NPI:1811025828
Name:BACHMANN, RODERICK JOHN (DPM)
Entity Type:Individual
Prefix:
First Name:RODERICK
Middle Name:JOHN
Last Name:BACHMANN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:283 WEIRS RD
Mailing Address - Street 2:UNIT #4
Mailing Address - City:GILFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03249-6669
Mailing Address - Country:US
Mailing Address - Phone:603-524-5671
Mailing Address - Fax:
Practice Address - Street 1:283 WEIRS RD
Practice Address - Street 2:UNIT #4
Practice Address - City:GILFORD
Practice Address - State:NH
Practice Address - Zip Code:03249-6669
Practice Address - Country:US
Practice Address - Phone:603-524-5671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH131213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T87480Medicare UPIN
NHNH8245Medicare ID - Type Unspecified