Provider Demographics
NPI:1508848763
Name:MENARD, NORMAN P (OD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:P
Last Name:MENARD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 BELKNAP ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-3643
Mailing Address - Country:US
Mailing Address - Phone:603-742-5719
Mailing Address - Fax:603-743-5811
Practice Address - Street 1:65 BELKNAP ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-3643
Practice Address - Country:US
Practice Address - Phone:603-742-5719
Practice Address - Fax:603-743-5811
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-15
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0281152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH80007782Medicaid
NH80007782Medicaid
T25684Medicare UPIN
NHNH7782Medicare ID - Type Unspecified