Provider Demographics
NPI:1780676080
Name:CLUTTERBUCK, WILLIAM BRUCE (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BRUCE
Last Name:CLUTTERBUCK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:87 MCGREGOR ST
Mailing Address - Street 2:SUITE 3100
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-3731
Mailing Address - Country:US
Mailing Address - Phone:603-627-1887
Mailing Address - Fax:603-627-1890
Practice Address - Street 1:87 MCGREGOR ST
Practice Address - Street 2:SUITE 3100
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-3731
Practice Address - Country:US
Practice Address - Phone:603-627-1887
Practice Address - Fax:603-627-1890
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2008-05-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NHNH6411208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH82020205Medicaid
NH82020205Medicaid
NHNH0205Medicare ID - Type Unspecified