Organization
DARTMOUTH MEDICAL SCHOOL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILEY W. SOUBA M.D. (DEAN)
(603) 650-1200
Entity
Organization
Contact information
Practice address
33 RIP RD, HANOVER, NH 03755-1616
(603) 643-2903
Mailing address
33 RIP RD, HANOVER, NH 03755-1616
(603) 643-2903
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
4476
NH
Other
Enumeration date
07/12/2012
Last updated
07/12/2012
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