Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 21806 | NH |
Y | 208600000X | Surgeon | 21806 | NH |
N | 208200000X | Surgeon | MT209046 | PA |
N | 208600000X | Surgeon | MT209046 | PA |
NPI | 1013396522 |
---|---|
Provider Name | Dr. Olivier P Van Houtte |
First Address | Keene, NH 03431 |
Second Address | Keene, NH 03431 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2015 |
Last Update Date | 02/09/2021 |