Basic Information
Provider Information
NPI: 1245267426
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DEWHIRST
FirstName: WILLIAM
MiddleName: EDGAR
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 MEDICAL CENTER DR
Address2: DHMC. CRITICAL CARE MEDICINE/DEPT. OF ANESTHESIOLOGY
City: LEBANON
State: NH
PostalCode: 037561000
CountryCode: US
TelephoneNumber: 6036504642
FaxNumber:  
Practice Location
Address1: 1 MEDICAL CENTER DR
Address2: DHMC. CRITICAL CARE MEDICINE/DEPT. OF ANESTHESIOLOGY
City: LEBANON
State: NH
PostalCode: 037561000
CountryCode: US
TelephoneNumber: 6036504642
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/26/2006
LastUpdateDate: 07/27/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207LC0200X7519NHY Allopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine

ID Information
IDTypeStateIssuerDescription
100189405VT MEDICAID
3000194605NH MEDICAID


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