Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 15917 | NH |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 15917 | NH |
N | 207VG0400X | Gynecologist | 15917 | NH |
NPI | 1821281866 |
---|---|
Provider Name | Elisabeth D Erekson |
First Address | Bedford, NH 03110-6736 |
Second Address | South Portland, ME 04106-1999 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2007 |
Last Update Date | 20/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3083640 | (05) | NH |