Provider Demographics
NPI:1942453188
Name:OHMAN, KIMBERLY ANN (MD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
Last Name:OHMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:ANN
Other - Last Name:MUGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:M D
Mailing Address - Street 1:100 MCGREGOR ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-3730
Mailing Address - Country:US
Mailing Address - Phone:603-663-6478
Mailing Address - Fax:603-926-2853
Practice Address - Street 1:100 MCGREGOR ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-3730
Practice Address - Country:US
Practice Address - Phone:603-663-6478
Practice Address - Fax:603-926-2853
Is Sole Proprietor?:No
Enumeration Date:2008-10-31
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORLL17621207P00000X
NH14562207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHAA154908OtherHARVARD PILGRIM
NH1942453188OtherANTHEM BCBS NH
NHP00766523OtherRAILROAD MEDICARE
NH30208982Medicaid
NH001286601Medicare PIN