Healthcare Provider Details

I. General information

NPI: 1710923511
Provider Name (Legal Business Name): PORTSMOUTH EMERGENCY PHYSICIANS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 04/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 BORTHWICK AVE
PORTSMOUTH NH
03801-7128
US

IV. Provider business mailing address

333 BORTHWICK AVE
PORTSMOUTH NH
03801-7128
US

V. Phone/Fax

Practice location:
  • Phone: 603-433-4012
  • Fax: 603-433-5184
Mailing address:
  • Phone: 603-433-4012
  • Fax: 603-433-5184

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: DONAVON ALBERTSON
Title or Position: CHIEF
Credential: MD
Phone: 603-433-4012