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General NPI Number Information
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NPI Number | 1881801009
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Entity Type | Organization
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Legal Business Name | ORTHOPAEDIC AND RECONSTRUCTIVE SURGEONS OF SOUTHEASTERN NH
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 780 CENTRAL AVE
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City | DOVER
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State | NH
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Zip | 03820-3412
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Country | US
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Telephone | 603-749-5110
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Fax | 603-743-4765
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Provider Business Mailing Address
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Address Line | 780 CENTRAL AVE
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City | DOVER
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State | NH
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Zip | 03820-3412
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Country | US
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Telephone | 603-749-5110
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Fax | 603-743-4765
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. INGVARS J VITTANDS
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Credential | M.D.
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Telephone | 603-749-5110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 4623
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License Number State | NH
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