Healthcare Provider Details

I. General information

NPI: 1306103577
Provider Name (Legal Business Name): NATHANIEL C SEARS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2012
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 BORTHWICK AVE STE 200E
PORTSMOUTH NH
03801-4184
US

IV. Provider business mailing address

155 BORTHWICK AVE STE 200E
PORTSMOUTH NH
03801-4184
US

V. Phone/Fax

Practice location:
  • Phone: 603-436-1773
  • Fax: 603-427-0655
Mailing address:
  • Phone: 603-436-1773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License NumberMD-44380
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number24997
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: