Healthcare Provider Details

I. General information

NPI: 1942443627
Provider Name (Legal Business Name): SASHA SOTIROVIC MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2009
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

789 CENTRAL AVE
DOVER NH
03820-2526
US

IV. Provider business mailing address

PO BOX 412503
BOSTON MA
02241-2503
US

V. Phone/Fax

Practice location:
  • Phone: 603-749-2266
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License NumberMS 202794
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number018502
License Number StateME
# 3
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number17236
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: