Basic Information
Provider Information
NPI: 1629092721
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ENGLUND
FirstName: ROBERT
MiddleName: J
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 71 CAMERON CV
Address2:  
City: MUNSONVILLE
State: NH
PostalCode: 034574109
CountryCode: US
TelephoneNumber: 6038479727
FaxNumber:  
Practice Location
Address1: 580 COURT ST.
Address2: THE CHESHIRE MEDICAL CENTER
City: KEENE
State: NH
PostalCode: 03431
CountryCode: US
TelephoneNumber: 6033545400
FaxNumber: 6033546535
Other Information
ProviderEnumerationDate: 07/26/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X5528NHY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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