Individual
JWALANT K VADALIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
138 WEBSTER STREET, MANCHESTER, NH 03104
(603) 645-5977
(603) 645-5980
Mailing address
P.O. BOX 3300, MANCHESTER, NH 03105
(603) 645-5977
(603) 645-5980
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
9203
NH
2084P0805X
Geriatric Psychiatry Physician
Primary
9203
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0108830Y0NH01
ANTHEM
—
05
—
3071621
—
NH
05
—
80003103
—
NH
Enumeration date
09/28/2005
Last updated
06/12/2019
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