Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 12838 | NH |
NPI | 1356370902 |
---|---|
Provider Name | Dr. Peter Michael Clemons |
First Address | Bedford, NH 03110-6736 |
Second Address | Bedford, NH 03110-6736 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 25/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
141326 | (02) | |
30205434 | (05) | NH |