Provider Demographics
NPI:1508836735
Name:EMLEY, WARREN E (MD)
Entity Type:Individual
Prefix:
First Name:WARREN
Middle Name:E
Last Name:EMLEY
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 1:23 DWINELL DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2512
Mailing Address - Country:US
Mailing Address - Phone:603-224-2353
Mailing Address - Fax:603-226-0727
Practice Address - Street 1:194 PLEASANT ST
Practice Address - Street 2:STE 2
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2952
Practice Address - Country:US
Practice Address - Phone:603-224-2353
Practice Address - Fax:603-226-0727
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH5352207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH81044056Medicaid
NHEMNH4056Medicare ID - Type Unspecified
NH81044056Medicaid