Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 9842 | NH |
N | 207QA0401X | Family Doctor - Addiction Medicine | 9842 | NH |
NPI | 1831188697 |
---|---|
Provider Name | Judith M. Mccole |
First Address | Bedford, NH 03110-6042 |
Second Address | Bedford, NH 03110-6042 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2005 |
Last Update Date | 18/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01-40463 | UHC (01) | NH |
0400276YPNH02 | ANTHEM ACES # (01) | NH |
080147624 | RR MEDICARE (01) | |
2177680 | AETNA (01) | NH |
30010284 | (05) | NH |
338600 | CIGNA (01) | NH |
406450 | TUFTS (01) | NH |
G26261 | (02) | NH |
G26261 | ANTHEM UPIN REFERRING # (01) | NH |
G26261 | HPHC (01) | NH |
P695442 | OXFORD (01) | NH |