Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | 3328 MA | MA |
Y | 204C00000X | Sports Medicine Doctor | 3980 | NH |
NPI | 1770834509 |
---|---|
Provider Name | Ms. Sharon Louise Ducker |
First Address | Salem, NH 03079-3174 |
Second Address | Salem, NH 03079-3174 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2012 |
Last Update Date | 06/02/2013 |