Provider Demographics
NPI:1851722417
Name:CLEARCHOICEMD, PLLC
Entity Type:Organization
Organization Name:CLEARCHOICEMD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAMPERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-526-4635
Mailing Address - Street 1:10 FERRY ST STE 302
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5081
Mailing Address - Country:US
Mailing Address - Phone:603-526-4635
Mailing Address - Fax:603-526-8283
Practice Address - Street 1:798 ROUTE 302
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:VT
Practice Address - Zip Code:05641-2305
Practice Address - Country:US
Practice Address - Phone:802-744-0138
Practice Address - Fax:802-622-0836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-09
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1022955Medicaid
NH3126640Medicaid
NH3096072Medicaid
NH3132319Medicaid
NH3126641Medicaid
NH3135935Medicaid
NH3111584Medicaid
NH3114986Medicaid
NH3119431Medicaid
NH3126642Medicaid
NH3133069Medicaid
ME1851722417Medicaid
NH3124083Medicaid