Basic Information
| Provider Information | |||||||||
| NPI: | 1568438281 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BREUDER | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3 NEWFANE RD | ||||||||
| Address2: | |||||||||
| City: | BEDFORD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 031104844 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6034710230 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 718 SMYTH RD | ||||||||
| Address2: | VA MEDICAL CENTER (11) | ||||||||
| City: | MANCHESTER | ||||||||
| State: | NH | ||||||||
| PostalCode: | 031047004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6036244366 | ||||||||
| FaxNumber: | 6036266576 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2083A0100X | 9537 | NH | Y | Allopathic & Osteopathic Physicians | Preventive Medicine | Aerospace Medicine | 2083A0100X | 35042743 | OH | N | Allopathic & Osteopathic Physicians | Preventive Medicine | Aerospace Medicine | 2083A0100X | 45053 | MA | N | Allopathic & Osteopathic Physicians | Preventive Medicine | Aerospace Medicine |
No ID Information.