Provider Demographics
NPI:1902816093
Name:STAUBER, JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:STAUBER
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 1:82 STOWELL RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-4717
Mailing Address - Country:US
Mailing Address - Phone:603-472-3912
Mailing Address - Fax:
Practice Address - Street 1:GOFFSTOWN PRIMARY CARE 542 MAST ROAD
Practice Address - Street 2:
Practice Address - City:GOFFSTOWN
Practice Address - State:NH
Practice Address - Zip Code:03045-5258
Practice Address - Country:US
Practice Address - Phone:603-647-9888
Practice Address - Fax:603-663-8015
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH11467207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H51128Medicare UPIN