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General NPI Number Information
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NPI Number | 1033705249
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Entity Type | Organization
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Legal Business Name | SURGICAL ASSISTANTS OF NEW HAMPSHIRE LLC
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Dates
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Enumeration Date | 12/12/2020
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Last Update Date | 04/08/2021
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Provider Practice Location Address
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Address Line | 3 EXECUTIVE PARK DR STE 201
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City | BEDFORD
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State | NH
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Zip | 03110-6954
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Country | US
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Telephone | 603-836-3498
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Fax |
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Provider Business Mailing Address
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Address Line | 3 EXECUTIVE PARK DR STE 201
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City | BEDFORD
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State | NH
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Zip | 03110-6954
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Country | US
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Telephone | 603-836-3498
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR/SURGICAL ASSISTANT
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Name | MICHAEL ALEXANDER STAFFORD
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Credential | CSA
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Telephone | 901-831-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number |
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License Number State |
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