Healthcare Provider Details

I. General information

NPI: 1801991351
Provider Name (Legal Business Name): STEVE A JOSELOW M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 05/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 HAMPTON RD
EXETER NH
03833-4807
US

IV. Provider business mailing address

401 ANDOVER ST SUITE 101
NORTH ANDOVER MA
01845-5076
US

V. Phone/Fax

Practice location:
  • Phone: 603-772-4684
  • Fax: 603-772-5206
Mailing address:
  • Phone: 978-691-5690
  • Fax: 978-691-5693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number7053
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number012501
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: