Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | 16634 | NH |
Y | 2081P2900X | Pain Medicine | 16634 | NH |
N | 2081P2900X | Pain Medicine | 253233 | MA |
N | 2081P2900X | Pain Medicine | C1-0009679 | DE |
NPI | 1669659793 |
---|---|
Provider Name | Dr. Jeremy Giere Collins |
First Address | Concord, NH 03301 |
Second Address | Concord, NH 03301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2008 |
Last Update Date | 08/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3097859 | (05) | NH |