1376597534 NPI number — PATRICK J. MORHUN, MD, PROFESSIONAL CORPORATION

Table of content: (NPI 1376597534)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376597534 NPI number — PATRICK J. MORHUN, MD, PROFESSIONAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PATRICK J. MORHUN, MD, PROFESSIONAL CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1376597534
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/06/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 350
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ETNA
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03750-0350
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-448-6008
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6 S PARK ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEBANON
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03766-1326
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-448-6008
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MORHUN
Authorized Official First Name:
PATRICK
Authorized Official Middle Name:
JAMES
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
603-448-6008

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  9931 , 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: 30010196 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0RE4390 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".




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