Basic Information
| Provider Information | |||||||||
| NPI: | 1063415412 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CONWAY | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | C. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 250 PLEASANT STREET | ||||||||
| Address2: | YEAPLE BUILDING | ||||||||
| City: | CONCORD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6032287200 | ||||||||
| FaxNumber: | 6032287307 | ||||||||
| Practice Location | |||||||||
| Address1: | 250 PLEASANT STREET | ||||||||
| Address2: | YEAPLE BUILDING | ||||||||
| City: | CONCORD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6032287200 | ||||||||
| FaxNumber: | 6032287307 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2005 | ||||||||
| LastUpdateDate: | 01/08/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 11192 | NH | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 2139331 | 01 | NH | CIGNA ID | OTHER | 3098221 | 01 | NH | AETNA ID | OTHER | 01Y003186NH01 | 01 | NH | ANTHEM ID | OTHER | 222594672 | 01 | NH | GREATWEST HEALTHCARE | OTHER | 80300001 | 05 | NH | MEDICAID | 160052164 | 01 | NH | RAILROAD MEDICARE ID | OTHER | 222594672 | 01 | NH | HEALTHCARE VALUE MANAGE # | OTHER | 222594672 | 01 | NH | PRIVATE HEALTHCARE ID | OTHER | 371522 | 01 | NH | MVP HEALTHCARE ID | OTHER | 07-41330 | 01 | NH | UNITED HEALTH CARE ID | OTHER | 222594672 | 01 | NH | TRICARE ID | OTHER | NH2056 | 01 | NH | HARVARD PILGRIM ID | OTHER |