Provider Demographics
NPI:1841204583
Name:CORMIER, MARYANNE (DC)
Entity Type:Individual
Prefix:
First Name:MARYANNE
Middle Name:
Last Name:CORMIER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 RANGE RD
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-2026
Mailing Address - Country:US
Mailing Address - Phone:603-893-6310
Mailing Address - Fax:603-892-2841
Practice Address - Street 1:58 RANGE RD
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087-2026
Practice Address - Country:US
Practice Address - Phone:603-893-6310
Practice Address - Fax:603-893-2841
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH236-0686C111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH04-65350OtherUNITED HEALTHCARE
NH020417401OtherNGS AMERICAN
NH1163089OtherFIRST HEALTH
NHY39724OtherBCBS MA
NH020417401OtherBENEFIT ADMINISTRATORS
NH0504627Y0NH01OtherANTHEM
NH544350OtherAETNA
NHNA1572OtherHARVARD PILGRIM
NHGA44-04092OtherUNITED HEALTHCARE- GA
NH020417401OtherHEALTHCARE MANAGEMENT
NH5411OtherCIGNA
NH020417401OtherGREAT WEST
NH020417401OtherMAIL HANDLERS
NH020417401OtherUNICARE
NH761532OtherTUFTS HEALTH PLAN
NHRE2188OtherBCBS MA
NHNA1572OtherHARVARD PILGRIM