Provider Demographics
NPI:1922078153
Name:ALDRIDGE, SAMUEL C (MD)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:C
Last Name:ALDRIDGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 PLEASANT ST.
Mailing Address - Street 2:MEMORIAL BUILDING, WEST, GROUND FLOOR
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2548
Mailing Address - Country:US
Mailing Address - Phone:603-415-6400
Mailing Address - Fax:603-227-7595
Practice Address - Street 1:246 PLEASANT ST.
Practice Address - Street 2:MEMORIAL BUILDING, WEST, GROUND FLOOR
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2548
Practice Address - Country:US
Practice Address - Phone:603-415-6400
Practice Address - Fax:603-227-7595
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH92952086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH4147495OtherMVP
NH1421203OtherCIGNA
NH3369423OtherAETNA
NH0109893Y0NH01OtherANTHEM
NH30007843Medicaid
NHNH2344OtherHARVARD PILGRIM HLTHCARE
NHF54366Medicare UPIN
NH1421203OtherCIGNA