Basic Information
| Provider Information | |||||||||
| NPI: | 1346424934 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MICHAEL A.H. REMAR, MD, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 168 KINSLEY ST | ||||||||
| Address2: | SUITE LL | ||||||||
| City: | NASHUA | ||||||||
| State: | NH | ||||||||
| PostalCode: | 030603634 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6035980455 | ||||||||
| FaxNumber: | 6035980456 | ||||||||
| Practice Location | |||||||||
| Address1: | 168 KINSLEY ST | ||||||||
| Address2: | SUITE LL | ||||||||
| City: | NASHUA | ||||||||
| State: | NH | ||||||||
| PostalCode: | 030603634 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6035980455 | ||||||||
| FaxNumber: | 6035980456 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/19/2007 | ||||||||
| LastUpdateDate: | 12/19/2007 | ||||||||
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| AuthorizedOfficialLastName: | TAYLOR | ||||||||
| AuthorizedOfficialFirstName: | JOY | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 6035980455 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 30213004 | 05 | NH | MEDICAID |