Provider Demographics
NPI:1780250738
Name:AFFIRM MEDICAL GROUP PLLC
Entity type:Organization
Organization Name:AFFIRM MEDICAL GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:603-276-0024
Mailing Address - Street 1:20 W PARK ST STE 421
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03766-6308
Mailing Address - Country:US
Mailing Address - Phone:603-276-0024
Mailing Address - Fax:
Practice Address - Street 1:20 W PARK ST STE 421
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-6308
Practice Address - Country:US
Practice Address - Phone:603-276-0024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Multi-Specialty