Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 2449 | NH |
NPI | 1851483192 |
---|---|
Provider Name | Dr. Charles Hamman Henry |
First Address | Keene, NH 03431-3421 |
Second Address | Keene, NH 03431-3421 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30005801 | (05) | NH |
U01922 | (02) | NH |