Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 9985 | NH |
N | 207QA0401X | Family Doctor - Addiction Medicine | 9985 | NH |
NPI | 1184618852 |
---|---|
Provider Name | Mr. Bertrand P Cole |
First Address | Somersworth, NH 03878-1543 |
Second Address | Somersworth, NH 03878-1543 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2005 |
Last Update Date | 20/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3075320 | (05) | NH |
F65115 | (02) | NH |