MEDICARE: WAYNE K. STADELMANN 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	2086S0122X	Plastic and Reconstructive Surgery Physician	RE7068	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932107216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WAYNE K. STADELMANN MD

Provider Business Mailing Address
First Line	:	246 PLEASANT ST
Second Line	:	SUITE 210
City	:	CONCORD
State	:	NH
Zip	:	03301-2548
Country	:	US
Telephone Number	:	603-224-5200
Fax Number	:	603-224-5091

Provider Business Practice Location Address
First Line	:	246 PLEASANT ST
Second Line	:	SUITE 210
City	:	CONCORD
State	:	NH
Zip	:	03301-2588
Country	:	US
Telephone Number	:	603-224-5200
Fax Number	:	603-224-5091

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

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	02/03/2011

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