MEDICARE: DR. ANDREW RYAN SPECTOR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	12632	NH

General Provider Information

NPI Number	:	1750367884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW RYAN SPECTOR MD

Provider Business Mailing Address
First Line	:	30 CANTON ST
Second Line	:
City	:	MANCHESTER
State	:	NH
Zip	:	03103-3524
Country	:	US
Telephone Number	:	603-622-3623
Fax Number	:	603-625-5483

Provider Business Practice Location Address
First Line	:	30 CANTON ST
Second Line	:
City	:	MANCHESTER
State	:	NH
Zip	:	03103-3524
Country	:	US
Telephone Number	:	603-622-3623
Fax Number	:	603-625-5483

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2005
Last Update Date	:	07/31/2014

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