Provider Demographics
NPI:1912221292
Name:STAUFFER, MARTHA E (MD)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:E
Last Name:STAUFFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 VILLAGE GRN
Mailing Address - Street 2:
Mailing Address - City:WEST LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03784-1502
Mailing Address - Country:US
Mailing Address - Phone:603-298-8028
Mailing Address - Fax:603-298-8028
Practice Address - Street 1:31 PLEASANT STREET #50
Practice Address - Street 2:
Practice Address - City:WEST LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03784-1502
Practice Address - Country:US
Practice Address - Phone:603-298-8028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-16
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH5885207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology