Individual
MICHELLE DIANE TYLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 MEDICAL CENTER DR, DHMC DEPARTMENT OF PEDIATRICS, LEBANON, NH 03756
(603) 653-9850
Mailing address
1 MEDICAL CENTER DR, DHMC DEPARTMENT OF PEDIATRICS, LEBANON, NH 03756-1000
(603) 653-9663
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
16197
NH
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
16197
NH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1021949
—
VT
05
—
3086958
—
NH
Enumeration date
04/11/2010
Last updated
05/22/2018
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