Provider Demographics
NPI:1518051887
Name:FAHMY, RAEF M (DPM)
Entity Type:Individual
Prefix:DR
First Name:RAEF
Middle Name:M
Last Name:FAHMY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 CONSTITUTION DR
Mailing Address - Street 2:SUITE #2
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6076
Mailing Address - Country:US
Mailing Address - Phone:603-471-9933
Mailing Address - Fax:603-471-9944
Practice Address - Street 1:18 CONSTITUTION DR
Practice Address - Street 2:SUITE #2
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6076
Practice Address - Country:US
Practice Address - Phone:603-471-9933
Practice Address - Fax:603-471-9944
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0244213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH480017614OtherMEDICARE RAILROAD
NH30011061Medicaid
NH30010840Medicaid
NH480017614OtherMEDICARE RAILROAD
NHLX0038Medicare PIN
NH30010840Medicaid