Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 10266 | NH |
NPI | 1013969005 |
---|---|
Provider Name | Suzanne Davey Shipman |
First Address | Lebanon, NH 03766-2694 |
Second Address | Lebanon, NH 03766-2647 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 08/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00069162 | BCBS VERMONT (01) | VT |
1012312 | (05) | VT |
30011449 | (05) | NH |
3036161 | CIGNA (01) | NH |
796675 | MVP (01) | NH |
AA52429 | HARVARD PILGRIM (01) | NH |
G75657 | (02) | NH |