Provider Demographics
NPI:1063415412
Name:CONWAY, DAVID C (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
Last Name:CONWAY
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 1:250 PLEASANT STREET
Mailing Address - Street 2:YEAPLE BUILDING
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301
Mailing Address - Country:US
Mailing Address - Phone:603-228-7200
Mailing Address - Fax:603-228-7307
Practice Address - Street 1:250 PLEASANT STREET
Practice Address - Street 2:YEAPLE BUILDING
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301
Practice Address - Country:US
Practice Address - Phone:603-228-7200
Practice Address - Fax:603-228-7307
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11192207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH2139331OtherCIGNA ID
NH3098221OtherAETNA ID
NH01Y003186NH01OtherANTHEM ID
NH222594672OtherGREATWEST HEALTHCARE
NH80300001Medicaid
NH160052164OtherRAILROAD MEDICARE ID
NH222594672OtherHEALTHCARE VALUE MANAGE #
NH222594672OtherPRIVATE HEALTHCARE ID
NH371522OtherMVP HEALTHCARE ID
NH07-41330OtherUNITED HEALTH CARE ID
NH222594672OtherTRICARE ID
NHNH2056OtherHARVARD PILGRIM ID
NHE57601Medicare UPIN
NHRE6201Medicare ID - Type Unspecified