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Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
55 HIGH ST STE 301, HAMPTON, NH 03842-2213
(603) 601-7762
(603) 601-6040
Mailing address
55 HIGH ST STE 301, HAMPTON, NH 03842-2213
(603) 601-7762
(603) 601-6040

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
11198
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3076239
NH
Enumeration date
03/23/2006
Last updated
05/12/2022
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