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General NPI Number Information
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NPI Number | 1477572832
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Entity Type | Individual
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Provider Name | DONALD OWEN KOLLISCH MD
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Gender | Male
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 05/07/2013
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Provider Practice Location Address
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Address Line | 93 E WHEELOCK ST
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City | HANOVER
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State | NH
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Zip | 03755-1605
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Country | US
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Telephone | 603-643-5572
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Fax |
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Provider Business Mailing Address
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Address Line | 93 E WHEELOCK ST
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City | HANOVER
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State | NH
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Zip | 03755-1605
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Country | US
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Telephone | 603-643-5572
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 6251
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License Number State | NH
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