Individual
MR. KERMIT MARK HUMMEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756-0001
(603) 650-6040
Mailing address
1 MEDICAL CENTER DR, LEBANON, NH 03756-0001
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1409
NH
363A00000X
Physician Assistant
—
—
Other
Enumeration date
08/22/2018
Last updated
10/22/2018
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