Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 10707 | NH |
NPI | 1033196720 |
---|---|
Provider Name | Dr. William Stephan |
First Address | Nashua, NH 03061-0808 |
Second Address | Nashua, NH 03060-3634 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2005 |
Last Update Date | 13/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
80002937 | (05) | NH |
E11284 | (02) | NH |