Provider Demographics
NPI:1841391208
Name:WESTBROOK, ANDREW GOCKE (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:GOCKE
Last Name:WESTBROOK
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 1:30 PILLSBURY STREET
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301
Mailing Address - Country:US
Mailing Address - Phone:603-224-4093
Mailing Address - Fax:603-230-5687
Practice Address - Street 1:30 PILLSBURY STREET
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301
Practice Address - Country:US
Practice Address - Phone:603-224-4093
Practice Address - Fax:603-230-5687
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200301078207Q00000X, 207QH0002X
NH14824207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30209759Medicaid
NC891344MMedicaid
NC891344MMedicaid
NH30209759Medicaid