Provider Demographics
NPI:1215921986
Name:GALLAGHER, MAUREEN (MD)
Entity type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:
Last Name:GALLAGHER
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 1:55 HIGH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03842-2213
Mailing Address - Country:US
Mailing Address - Phone:603-929-2137
Mailing Address - Fax:603-929-7482
Practice Address - Street 1:55 HIGH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842-2213
Practice Address - Country:US
Practice Address - Phone:603-929-2137
Practice Address - Fax:603-929-7482
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11020207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3087500Medicaid
NH3087500Medicaid
NHH22449Medicare UPIN
ME243350099Medicaid
110206493Medicare PIN
NHMX4172Medicare PIN