MEDICARE: ANASTASIOS KONSTANTAKOS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	35007	NH
2	208600000X	Surgery Physician	11339	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	124057900	OTHER	MT	MDCD PIN
2	000097436	OTHER	MT	BCBS PIN

General Provider Information

NPI Number	:	1902892110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANASTASIOS KONSTANTAKOS MD

Provider Business Mailing Address
First Line	:	250 PLEASANT ST
Second Line	:
City	:	CONCORD
State	:	NH
Zip	:	03301-2598
Country	:	US
Telephone Number	:	603-227-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	246 PLEASANT ST
Second Line	:
City	:	CONCORD
State	:	NH
Zip	:	03301-2548
Country	:	US
Telephone Number	:	603-224-1725
Fax Number	:	603-227-7557

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	09/16/2025

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