Provider Demographics
NPI:1184618852
Name:COLE, BERTRAND P (DO)
Entity type:Individual
Prefix:MR
First Name:BERTRAND
Middle Name:P
Last Name:COLE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 ROUTE 108
Mailing Address - Street 2:
Mailing Address - City:SOMERSWORTH
Mailing Address - State:NH
Mailing Address - Zip Code:03878-1543
Mailing Address - Country:US
Mailing Address - Phone:603-692-3166
Mailing Address - Fax:603-692-3168
Practice Address - Street 1:255 ROUTE 108
Practice Address - Street 2:
Practice Address - City:SOMERSWORTH
Practice Address - State:NH
Practice Address - Zip Code:03878-1543
Practice Address - Country:US
Practice Address - Phone:603-692-3166
Practice Address - Fax:603-692-3168
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH9985207Q00000X, 207QA0401X, 2083A0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3075320Medicaid
NH80113910OtherRR MEDICARE
ME251570099Medicaid
NH80113910OtherRR MEDICARE
NHRE4458Medicare PIN