Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 550-1198 | NH |
NPI | 1013027564 |
---|---|
Provider Name | Dr. Keith Andrew Weiss |
First Address | Concord, NH 03301-5611 |
Second Address | Concord, NH 03301-5611 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0502688Y0NH01 | ANTHEM BLUE CROSS BLUE SH (01) | NH |
1617316 | CIGNA (01) | NH |
U84414 | HARVARD PILGRIM HC (01) | NH |