Healthcare Provider Details

I. General information

NPI: 1902892110
Provider Name (Legal Business Name): ANASTASIOS KONSTANTAKOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2005
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 PLEASANT ST
CONCORD NH
03301-2548
US

IV. Provider business mailing address

250 PLEASANT ST
CONCORD NH
03301-2598
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-1725
  • Fax: 603-227-7557
Mailing address:
  • Phone: 603-227-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35007
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number11339
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: