Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RN0300X | Nephrologist | 10076 | NH |
Y | 2080P0210X | Pediatric Nephrologist | 10076 | NH |
NPI | 1457428013 |
---|---|
Provider Name | Dr. Michael Charles Chobanian |
First Address | Lebanon, NH 03756-1000 |
Second Address | Lebanon, NH 03756-1000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 13/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0RE4563 | (05) | VT |
30010842 | (05) | NH |
B52054 | (02) |