Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 14529 | NH |
Y | 2080P0210X | Pediatric Nephrologist | 14529 | NH |
NPI | 1720061153 |
---|---|
Provider Name | Adam R Weinstein |
First Address | Lebanon, NH 03756-0001 |
Second Address | Lebanon, NH 03756-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2005 |
Last Update Date | 29/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1016636 | (05) | VT |
30208943 | (05) | NH |
I37100 | (02) |