Provider Demographics
NPI:1649683194
Name:COLBY, BENJAMIN S (MD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:S
Last Name:COLBY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:250 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-7559
Mailing Address - Country:US
Mailing Address - Phone:603-228-7200
Mailing Address - Fax:603-227-7562
Practice Address - Street 1:19 FARRINGTON CORNER RD
Practice Address - Street 2:
Practice Address - City:HOPKINTON
Practice Address - State:NH
Practice Address - Zip Code:03229-2020
Practice Address - Country:US
Practice Address - Phone:603-228-7575
Practice Address - Fax:603-227-7565
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH18412207Q00000X
MEEC141099390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program