Individual
DR. CHARLES M SIDELL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
630 MAIN ST, GORHAM, NH 03581-4900
(603) 752-7727
(603) 752-2820
Mailing address
630 MAIN ST, GORHAM, NH 03581-4900
(603) 752-7727
(603) 752-2820
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
531-0498
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0501745Y0NH01
ANTHEM BLUE CROSS BLUE SH
NH
05
—
30250401
—
NH
01
—
41581
CIGNA
NH
Enumeration date
07/20/2005
Last updated
07/08/2007
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