Provider Demographics
NPI:1063824043
Name:WERTH, JEREMY BOEGEL (MD)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:BOEGEL
Last Name:WERTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 E MAIN ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:WARNER
Mailing Address - State:NH
Mailing Address - Zip Code:03278-4421
Mailing Address - Country:US
Mailing Address - Phone:603-456-6106
Mailing Address - Fax:603-456-6176
Practice Address - Street 1:2 E MAIN ST UNIT 2
Practice Address - Street 2:
Practice Address - City:WARNER
Practice Address - State:NH
Practice Address - Zip Code:03278-4421
Practice Address - Country:US
Practice Address - Phone:603-456-6106
Practice Address - Fax:603-456-6176
Is Sole Proprietor?:No
Enumeration Date:2014-05-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH18350208M00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist