Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 2472 | NH |
Y | 213EG0000X | General Practice | 2472 | NH |
NPI | 1003940420 |
---|---|
Provider Name | Dr. Diane E. Benoit |
First Address | Concord, NH 03301-4021 |
Second Address | Concord, NH 03301-4021 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2007 |
Last Update Date | 08/07/2007 |