Healthcare Provider Details

I. General information

NPI: 1083239529
Provider Name (Legal Business Name): MICHAEL LAWRENCE TOSCANO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2020
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 DURHAM RD STE 205
DOVER NH
03820-4380
US

IV. Provider business mailing address

15 DURHAM RD STE 205
DOVER NH
03820-4380
US

V. Phone/Fax

Practice location:
  • Phone: 207-475-0100
  • Fax:
Mailing address:
  • Phone: 248-338-5392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberDO4072
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number34482
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: