Provider Demographics
NPI:1740259530
Name:STEBBINS, PHILIP CARY (MD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:CARY
Last Name:STEBBINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:22 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-5900
Mailing Address - Country:US
Mailing Address - Phone:603-893-7905
Mailing Address - Fax:603-898-6106
Practice Address - Street 1:22 MAIN ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-5900
Practice Address - Country:US
Practice Address - Phone:603-893-7905
Practice Address - Fax:603-898-6106
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-15
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH6432207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA732037OtherTUFTS HEALTHCARE
3272346OtherAETNA US HEALTHCARE
NH30203650Medicaid
MA1280817OtherFALLON HEALTHCARE
MA1280817OtherUS FAMILY HEALTHCARE
MAJ19502OtherBLUE SHIELD OF MASSACHUSE
NH0100251YPNH02OtherANTHEM BLUE SHIELD OF NH
MA710521OtherHARVARD PILGRIM HEALTHCAR
P00129447OtherRAILROAD MEDICARE
P00129447OtherRAILROAD MEDICARE
MA710521OtherHARVARD PILGRIM HEALTHCAR