1740259530 NPI number — DR. PHILIP CARY STEBBINS M.D.

Table of content: TODD MORNINGSTAR (NPI 1427507227)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740259530 NPI number — DR. PHILIP CARY STEBBINS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STEBBINS
Provider First Name:
PHILIP
Provider Middle Name:
CARY
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:
1740259530
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/28/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22 MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALEM
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03079-5900
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-893-7905
Provider Business Mailing Address Fax Number:
603-898-6106

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
22 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALEM
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03079-5900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-893-7905
Provider Business Practice Location Address Fax Number:
603-898-6106
Provider Enumeration Date:
03/15/2006

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:  NH6432 , 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: 732037 . This is a "TUFTS HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 3272346 . This is a "AETNA US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 30203650 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1280817 . This is a "FALLON HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1280817 . This is a "US FAMILY HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: J19502 . This is a "BLUE SHIELD OF MASSACHUSE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0100251YPNH02 . This is a "ANTHEM BLUE SHIELD OF NH" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 710521 . This is a "HARVARD PILGRIM HEALTHCAR" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: P00129447 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".




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