Provider Demographics
NPI:1053389817
Name:FERRIS, DAVID V (DO)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:V
Last Name:FERRIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 MOUNT EUSTIS RD
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561-3712
Mailing Address - Country:US
Mailing Address - Phone:603-444-2464
Mailing Address - Fax:
Practice Address - Street 1:25 MOUNT EUSTIS RD
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:NH
Practice Address - Zip Code:03561-3712
Practice Address - Country:US
Practice Address - Phone:603-444-7070
Practice Address - Fax:603-444-2769
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH13425207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME302860099Medicaid
VT1013183Medicaid
NH80300008Medicaid
ME302860099Medicaid