Provider Demographics
NPI:1386621134
Name:HALLQUIST, ROBIN A (MD)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:A
Last Name:HALLQUIST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ROBIN
Other - Middle Name:A
Other - Last Name:ARN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 303
Mailing Address - Street 2:
Mailing Address - City:TWIN MOUNTAIN
Mailing Address - State:NH
Mailing Address - Zip Code:03595-0303
Mailing Address - Country:US
Mailing Address - Phone:603-846-2250
Mailing Address - Fax:603-846-2251
Practice Address - Street 1:529 ROUTE 3 SOUTH
Practice Address - Street 2:
Practice Address - City:TWIN MOUNTAIN
Practice Address - State:NH
Practice Address - Zip Code:03595
Practice Address - Country:US
Practice Address - Phone:603-846-2250
Practice Address - Fax:603-846-2251
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11044207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE58585603OtherMEDICARE
NH30201067Medicaid
VTORE5856Medicaid
NH30201067Medicaid