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General NPI Number Information
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NPI Number | 1326408709
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Entity Type | Organization
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Legal Business Name | EPHREM MEDICAL SERVICES, LLC
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Dates
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Enumeration Date | 02/29/2016
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Last Update Date | 02/29/2016
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Provider Practice Location Address
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Address Line | 304 TURNER WAY
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City | LACONIA
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State | NH
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Zip | 03246-1691
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Country | US
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Telephone | 603-455-8175
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Fax |
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Provider Business Mailing Address
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Address Line | 304 TURNER WAY
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City | LACONIA
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State | NH
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Zip | 03246-1691
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Country | US
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Telephone | 603-455-8175
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. VERCIN S EPHREM
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Credential | M.D
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Telephone | 603-455-8175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 13040
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License Number State | NH
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