Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 15835 | NH |
Y | 208600000X | Surgeon | 15835 | NH |
NPI | 1013915602 |
---|---|
Provider Name | Robert Knowles |
First Address | Peterborough, NH 03458-1200 |
Second Address | Peterborough, NH 03458-1200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2005 |
Last Update Date | 09/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002960301 | MEDICARE PTAN (01) | NH |
3077483 | (05) | NH |