Provider Demographics
NPI:1912917717
Name:MACCAUSLAND, OWEN (MD)
Entity type:Individual
Prefix:
First Name:OWEN
Middle Name:
Last Name:MACCAUSLAND
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 1:540 LAFAYETTE RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03842-3344
Mailing Address - Country:US
Mailing Address - Phone:603-926-0088
Mailing Address - Fax:603-926-2853
Practice Address - Street 1:789 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-2526
Practice Address - Country:US
Practice Address - Phone:603-740-2163
Practice Address - Fax:603-740-2246
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH8453207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30005150Medicaid
NH930055343OtherRAILROAD THRU SEACOAST ER
ME315810099Medicaid
NH0107899Y0NH01OtherBCBS THRU SEACOAST ER
NHE36871OtherHARVARD PILGRIM NH
NH0107899Y0NH01OtherBCBS THRU SEACOAST ER
NH30005150Medicaid
ME315810099Medicaid