Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 6861 | NH |
NPI | 1023189891 |
---|---|
Provider Name | Dr. Chengta Richard Dai |
First Address | Lewiston, ME 04243-7291 |
Second Address | Nashua, NH 03060 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 06/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3079372 | (05) | NH |
D03411 | (02) |