MEDICARE: EVGENY V TSEPLAEV 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	207R00000X	Internal Medicine Physician	46134	MN
2	207R00000X	Internal Medicine Physician	17244	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
2	46134	OTHER	MN	MEDICAL LICENSE

General Provider Information

NPI Number	:	1932109816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVGENY V TSEPLAEV MD

Provider Business Mailing Address
First Line	:	1 ELLIOT WAY
Second Line	:	HOSPITALISTS
City	:	MANCHESTER
State	:	NH
Zip	:	03103-3502
Country	:	US
Telephone Number	:	603-663-2271
Fax Number	:	603-663-2273

Provider Business Practice Location Address
First Line	:	1 ELLIOT WAY
Second Line	:	HOSPITALISTS
City	:	MANCHESTER
State	:	NH
Zip	:	03103-3502
Country	:	US
Telephone Number	:	603-663-2271
Fax Number	:	603-663-2273

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

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	09/02/2015

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