Basic Information
| Provider Information | |||||||||
| NPI: | 1124054515 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROW | ||||||||
| FirstName: | PETER | ||||||||
| MiddleName: | L | ||||||||
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| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 172 KINSLEY ST | ||||||||
| Address2: | |||||||||
| City: | NASHUA | ||||||||
| State: | NH | ||||||||
| PostalCode: | 030603648 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6035953061 | ||||||||
| FaxNumber: | 6038893774 | ||||||||
| Practice Location | |||||||||
| Address1: | 172 KINSLEY ST | ||||||||
| Address2: | EMERGENCY DEPT | ||||||||
| City: | NASHUA | ||||||||
| State: | NH | ||||||||
| PostalCode: | 030603648 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6035953061 | ||||||||
| FaxNumber: | 6038893774 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2006 | ||||||||
| LastUpdateDate: | 05/05/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207PE0004X | 13179 | NH | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | Emergency Medical Services |
ID Information
| ID | Type | State | Issuer | Description | 01Y010903NH01 | 01 | NH | ANTHEM | OTHER | 2122812 | 05 | MA | MEDICAID | P00370507 | 01 | RAILROAD MEDICARE | OTHER | 30206147 | 05 | NH | MEDICAID |