Provider Demographics
NPI:1952360430
Name:KOREN, JAMES PETER (MD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:PETER
Last Name:KOREN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 706
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03264-0706
Mailing Address - Country:US
Mailing Address - Phone:603-481-8757
Mailing Address - Fax:603-238-2163
Practice Address - Street 1:16 HOSPITAL ROAD
Practice Address - Street 2:SPEARE SURGICAL SERVICES
Practice Address - City:PLYMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03264
Practice Address - Country:US
Practice Address - Phone:603-536-5670
Practice Address - Fax:603-536-1544
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD419656208600000X
NH13971208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001950383Medicaid
AA126600OtherHARVARD PILGRIM
0591457OtherCIGNA
PA866601OtherMEDICARE GROUP #
VT1015430Medicaid
1952360430OtherUNITED HEALTHCARE
NH30208058Medicaid
NH3072796Medicaid
1952360430OtherUNITED HEALTHCARE
NH30208058Medicaid
VT1015430Medicaid