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General NPI Number Information
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NPI Number | 1154496909
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Entity Type | Organization
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Legal Business Name | CARROLL COUNTY GASTROENTEROLOGY, INC.
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 10/27/2010
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Provider Practice Location Address
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Address Line | 29 UNION ST
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City | WOLFEBORO
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State | NH
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Zip | 03894
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Country | US
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Telephone | 603-569-9681
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Fax | 603-569-9384
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Provider Business Mailing Address
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Address Line | PO BOX 878
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City | WOLFEBORO FALLS
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State | NH
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Zip | 03896-0878
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Country | US
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Telephone | 603-569-9681
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Fax | 603-569-9384
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Authorized Official
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Title or Position | ADMIN DIRECTOR
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Name | MRS. PATRICIA NOLAN BOWEN
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Credential |
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Telephone | 603-569-9681
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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