Provider Demographics
NPI:1992913032
Name:DEWAN, ANIL K (MD)
Entity type:Individual
Prefix:
First Name:ANIL
Middle Name:K
Last Name:DEWAN
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 1:1 HAMPTON ROAD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-4849
Mailing Address - Country:US
Mailing Address - Phone:603-778-8522
Mailing Address - Fax:603-778-1602
Practice Address - Street 1:1 HAMPTON ROAD
Practice Address - Street 2:SUITE 208
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-4849
Practice Address - Country:US
Practice Address - Phone:603-778-8522
Practice Address - Fax:603-778-1602
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH14583207ZP0102X
VA0101239605207ZC0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology