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

Table of content: DR. PHILIP CARY STEBBINS M.D. (NPI 1740259530)

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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