Provider Demographics
NPI:1316940802
Name:DREFFER, DOUGLAS R (MD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:R
Last Name:DREFFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BUTTRICK RD STE 102
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3417
Mailing Address - Country:US
Mailing Address - Phone:603-537-1300
Mailing Address - Fax:
Practice Address - Street 1:6 TSIENNETO RD STE 100
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038
Practice Address - Country:US
Practice Address - Phone:603-537-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH10861207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH01Y002400NH01OtherANTHEM ID# FHC
NH222594672OtherGREATWEST HEALTHCARE ID#
NHP00059817OtherRAIDROAD MEDICARE ID#
NH2139325OtherCIGNA ID#
NH30200816Medicaid
NHNH1855OtherHARVARD PILGRIM ID# FHC
NH01YP02400NH01OtherANTHEM ID #
NH222594672OtherHEALTH CARE VALUE MANAGE#
NH222594672OtherPRIVATE HEALTH CARE ID#
NH4126889OtherMVP ID#
NH01-40641OtherUNITED HEALTHCARE ID#
NH2500010OtherAETNA ID#
NHNH1835OtherHARVARD PILGRIM ID#