Individual
DR. EVADNE G MARCOLINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756
(603) 650-7254
Mailing address
1 MEDICAL CENTER DR, LEBANON, NH 03756-0001
(203) 432-0076
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
042.0014061
VT
207P00000X
Emergency Medicine Physician
Primary
19817
NH
2084A2900X
Neurocritical Care Physician
19817
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018339300
—
MD
01
—
P00725397
RAILROAD MEDICARE
MD
Enumeration date
10/18/2006
Last updated
09/06/2019
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