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General NPI Number Information
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NPI Number | 1932133030
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Entity Type | Individual
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Provider Name | MARSHALL ANDERSON GUILL III MD
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Gender | Male
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 12/05/2012
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Provider Practice Location Address
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Address Line | 18 OLD ETNA RD DH DEPT OF DERMATOLOGY
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City | LEBANON
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State | NH
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Zip | 03766
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Country | US
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Telephone | 603-650-3100
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Fax | 603-650-3174
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Provider Business Mailing Address
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Address Line | 1 MEDICAL CENTER DR DHMC DEPART OF MEDICINE/DERMATOLOGY
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City | LEBANON
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State | NH
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Zip | 03756-1000
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Country | US
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Telephone | 603-650-5000
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | G16239
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 14454
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | GA16239
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | 14454
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License Number State | NH
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