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General NPI Number Information
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NPI Number | 1255501300
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Entity Type | Organization
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Legal Business Name | THORACIC & VASCULAR ASSOCIATES
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Dates
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Enumeration Date | 03/05/2008
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Last Update Date | 06/05/2008
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Provider Practice Location Address
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Address Line | 200 GRIFFIN ROAD UNIT 6
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City | PORTSMOUTH
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State | NH
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Zip | 03801
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Country | US
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Telephone | 603-842-6060
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Fax |
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Provider Business Mailing Address
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Address Line | 267 ROUTE 108 UNIT A
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City | SOMERSWORTH
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State | NH
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Zip | 03878
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Country | US
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Telephone | 603-842-6060
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Fax |
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Authorized Official
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Title or Position | SURGEON/MEMBER
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Name | ROBERT C ORAM
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Credential | MD
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Telephone | 603-842-6060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 6905
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 6905
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License Number State | NH
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