Provider Demographics
NPI:1427106798
Name:FELDHUSEN, ADRIAN E (NHCM, CPM)
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:E
Last Name:FELDHUSEN
Suffix:
Gender:F
Credentials:NHCM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 ACADEMY RD
Mailing Address - Street 2:
Mailing Address - City:NEW IPSWICH
Mailing Address - State:NH
Mailing Address - Zip Code:03071-3700
Mailing Address - Country:US
Mailing Address - Phone:603-878-1190
Mailing Address - Fax:
Practice Address - Street 1:4 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:NH
Practice Address - Zip Code:03055-3724
Practice Address - Country:US
Practice Address - Phone:603-673-6010
Practice Address - Fax:603-673-6014
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1026176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH44Y011283NH01OtherANTHEM BLUE CROSS BLUE SH
MA0000ZBR995OtherBLUE CROSS BLUE SHIELD
NH30464445Medicaid
VT1010689Medicaid