Healthcare Provider Details

I. General information

NPI: 1649216177
Provider Name (Legal Business Name): GREATER NASHUA EMERGENCY PHYSICIANS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 05/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

172 KINSLEY ST
NASHUA NH
03060-3648
US

IV. Provider business mailing address

172 KINSLEY ST
NASHUA NH
03060-3648
US

V. Phone/Fax

Practice location:
  • Phone: 603-595-3061
  • Fax: 603-889-3774
Mailing address:
  • Phone: 603-595-3061
  • Fax: 603-889-3774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES S MARTIN
Title or Position: CHIEF
Credential: MD
Phone: 603-595-3061