Healthcare Provider Details

I. General information

NPI: 1346533015
Provider Name (Legal Business Name): AZAR A KORBEY MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2011
Last Update Date: 05/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 MAIN ST
SALEM NH
03079-5900
US

IV. Provider business mailing address

22 MAIN ST
SALEM NH
03079-5900
US

V. Phone/Fax

Practice location:
  • Phone: 603-893-7905
  • Fax: 603-898-6106
Mailing address:
  • Phone: 603-893-7905
  • Fax: 603-898-6106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number7069
License Number StateNH

VIII. Authorized Official

Name: DR. AZAR A KORBEY
Title or Position: OWNER
Credential: MD
Phone: 603-893-7905