Basic Information
| Provider Information | |||||||||
| NPI: | 1992913032 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DEWAN | ||||||||
| FirstName: | ANIL | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 HAMPTON ROAD | ||||||||
| Address2: | SUITE 208 | ||||||||
| City: | EXETER | ||||||||
| State: | NH | ||||||||
| PostalCode: | 038334849 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6037788522 | ||||||||
| FaxNumber: | 6037781602 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 HAMPTON ROAD | ||||||||
| Address2: | SUITE 208 | ||||||||
| City: | EXETER | ||||||||
| State: | NH | ||||||||
| PostalCode: | 038334849 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6037788522 | ||||||||
| FaxNumber: | 6037781602 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2007 | ||||||||
| LastUpdateDate: | 11/20/2009 | ||||||||
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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 | 207ZP0102X | 14583 | NH | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology | 207ZC0500X | 0101239605 | VA | N | Allopathic & Osteopathic Physicians | Pathology | Cytopathology |
No ID Information.