Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 4803 | NH |
NPI | 1063444727 |
---|---|
Provider Name | Dr. Michael B. Mayor |
First Address | Hanover, NH 03755-3908 |
Second Address | Hanover, NH 03755-3908 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 08/07/2007 |