| Document Date: 2014-03-26 13:22:08
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City City/Town / / Company Professional Corporation / NAIC GROUP & COMPANY / / Facility Hospital Inpatient Facility Severity / Hospital Outpatient Facility / Other Outpatient Facility / / IndustryTerm healthcare professionals / insurance / / Organization Insurance Department / Physical Therapy Department / Insured INSTITUTION / / Person John Does / / Position Physician / Attorney / Major / counsel for this defendant / counsel / defense counsel / ACTUARY / Surgeon / Dentist / Chiropractor / Podiatrist / Optometrist / Nurse / / Product Diagnosis Anesthesia Surgery Medication Obstetrics Treatment Monitoring Biomedical Equipment/Product Medication / / ProvinceOrState New Hampshire / / Technology 3g / /
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NEW HAMPSHIRE INSURANCE DEPARTMENT MAIL TO: NHID - ACTUARY MEDICAL PROFESSIONAL LIABILITY INSURANCE EARLY OFFER REQUEST REPORT