Provider Demographics
NPI:1366416109
Name:BUNDSCHUH, ALEXIS-ANN (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXIS-ANN
Middle Name:
Last Name:BUNDSCHUH
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 1:280 MAIN ST STE 210A
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-2920
Mailing Address - Country:US
Mailing Address - Phone:603-577-3080
Mailing Address - Fax:603-577-3081
Practice Address - Street 1:280 MAIN ST STE 210A
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-2920
Practice Address - Country:US
Practice Address - Phone:603-577-3080
Practice Address - Fax:603-577-3081
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH6872207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH00000023Medicaid
NHE16957OtherHARVARD PILGRIM
NH0101607YPNH01OtherANTHEM
NH1412776OtherUNITED HEALTHCARE
NH3113242003OtherCIGNA
NH1412776OtherUNITED HEALTHCARE
NHE16957Medicare UPIN