Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 10369 | NH |
Y | 208600000X | Surgeon | 10369 | NH |
N | 208200000X | Surgeon | 2005-01849 | NC |
N | 208600000X | Surgeon | 2005-01849 | NC |
NPI | 1023092632 |
---|---|
Provider Name | Dr. Andri Gaukur Olafsson |
First Address | Berlin, NH 03570-3531 |
Second Address | Berlin, NH 03570-3531 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2005 |
Last Update Date | 17/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G80305 | (02) | NH |