Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 0131289A | NH |
NPI | 1003911082 |
---|---|
Provider Name | Wesley A Merritt |
First Address | Durham, NH 03824 |
Second Address | Durham, NH 03824 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0505075Y0NH01 | ANTHEM BCBS (01) | NH |
30004830 | (05) | NH |
NA1709 | HARVARD PILGRIM HEALTHCAR (01) | NH |
U02221 | (02) |