Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 8112 | NH |
NPI | 1003854993 |
---|---|
Provider Name | Rebecca Anne Ewing |
First Address | Manchester, NH 03104 |
Second Address | Concord, NH 03301-4037 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2006 |
Last Update Date | 14/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30201313 | (05) | NH |
E42517 | (02) |