Individual
JOHNDAVID MAZICH STORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
ONE MEDICAL CENTER DR., LEBANON, NH 03756-0001
(603) 650-7254
Mailing address
ONE MEDICAL CENTER DR., LEBANON, NH 03756-0001
(603) 650-7254
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
042.0015510
VT
207P00000X
Emergency Medicine Physician
Primary
20519
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3122708
—
NH
05
—
6703741
—
VT
Enumeration date
03/24/2017
Last updated
04/13/2022
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