Provider Demographics
NPI:1396744413
Name:AFFILIATES IN PODIATRY
Entity type:Organization
Organization Name:AFFILIATES IN PODIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:N
Authorized Official - Last Name:MCCANN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:603-225-5281
Mailing Address - Street 1:248 PLEASANT ST
Mailing Address - Street 2:STE 203
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2588
Mailing Address - Country:US
Mailing Address - Phone:603-225-5281
Mailing Address - Fax:603-228-7095
Practice Address - Street 1:248 PLEASANT ST
Practice Address - Street 2:STE 203
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2588
Practice Address - Country:US
Practice Address - Phone:603-225-5281
Practice Address - Fax:603-228-7095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
NH213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30003710Medicaid
0274870001Medicare NSC
NHRE1165Medicare PIN
T95775Medicare UPIN