Individual
DOUGLAS EDWARD AMIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
240 S MAIN ST, WOLFEBORO, NH 03894-4411
(603) 569-7500
(603) 515-2031
Mailing address
240 S MAIN ST, WOLFEBORO, NH 03894-4411
(603) 569-7500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1031
NH
363A00000X
Physician Assistant
Primary
10381
GA
363A00000X
Physician Assistant
2211
AK
363A00000X
Physician Assistant
2684
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021137
KAISER COMMERCIAL NUMBER
CO
05
—
66500753
—
CO
Enumeration date
10/03/2008
Last updated
11/02/2021
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