1043214711 NPI number — DR. GREGORY J THESING M.D.

Table of content: DR. GREGORY J THESING M.D. (NPI 1043214711)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043214711 NPI number — DR. GREGORY J THESING M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
THESING
Provider First Name:
GREGORY
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043214711
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15 ANTRIM RD
Provider Second Line Business Mailing Address:
HDFH
Provider Business Mailing Address City Name:
HILLSBORO
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03244-5204
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-464-3434
Provider Business Mailing Address Fax Number:
603-464-3440

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15 ANTRIM RD
Provider Second Line Business Practice Location Address:
HDFH
Provider Business Practice Location Address City Name:
HILLSBORO
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03244-5204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-464-3434
Provider Business Practice Location Address Fax Number:
603-464-3440
Provider Enumeration Date:
06/09/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  9755 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0103007YPNH01 . This is a "ANTHEM ID#" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 2445134 . This is a "AETNA ID#" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 222594672 . This is a "HEALTHCARE VALUE MANANGE#" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 222594672 . This is a "GREATWEST HEALTHCARE ID#" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 07-04269 . This is a "TRICARE ID#" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: G44636 . This is a "HARVARD PILGRIM ID#" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: H005016 . This is a "TRICARE ID#" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 2139312 . This is a "CIGNA ID#" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 30010092 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 80199585 . This is a "RAILROAD MEDICARE ID#" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 0103007Y0NH01 . This is a "ANTHEM ID# FHC" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 222594672 . This is a "PRIVATE HEALTH CARE ID#" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 4126964 . This is a "MVP ID#" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 383153 . This is a "MVP-FHC BILLING NUMBER" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".




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