Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 9799 | NH |
N | 207P00000X | Emergency Physician | MD20347 | ME |
N | 207R00000X | Internist | 9799 | NH |
N | 111NI0900X | Internist | 9799 | NH |
Y | 207RA0401X | Internist - Addiction Medicine | 9799 | NH |
N | 208000000X | Pediatrician | 9799 | NH |
NPI | 1770502106 |
---|---|
Provider Name | Mark M Durcan |
First Address | New London, NH 03257-5881 |
Second Address | Scarborough, ME 04074-9593 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 17/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0108262Y0NH03 | ANTHEM (01) | NH |
0188107 | (05) | MA |
30201928 | (05) | NH |
69151 | TUFTS (01) | |
7067015 | AETNA (01) | |
7067015 | AETNA (01) | NH |
AA105262 | HARVARD PILGRIM (01) | |
G18766 | (02) | |
G18766 | NHBS RAN (01) | NH |
P00191358 | RAILROAD MEDICARE (01) |