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General NPI Number Information
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NPI Number | 1124483664
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Entity Type | Organization
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Legal Business Name | HUMBERTO VALDES JR MD PA
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Dates
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Enumeration Date | 12/29/2015
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Last Update Date | 12/29/2015
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Provider Practice Location Address
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Address Line | 196 WATER ST SUITE 15
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City | EXETER
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State | NH
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Zip | 03833-2422
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Country | US
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Telephone | 603-778-1721
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Fax |
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Provider Business Mailing Address
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Address Line | 196 WATER ST SUITE 15
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City | EXETER
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State | NH
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Zip | 03833-2422
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Country | US
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Telephone | 603-778-1721
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | HUMBERTO VALDES JR.
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Credential | M.D.
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Telephone | 603-778-1721
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | NH6284
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License Number State | NH
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