Healthcare Provider Details

I. General information

NPI: 1083605117
Provider Name (Legal Business Name): DAVID H STONE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2005
Last Update Date: 10/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER DR DHMC DEPARTMENT OF SURGERY
LEBANON NH
03756-1000
US

IV. Provider business mailing address

1 MEDICAL CENTER DR DHMC DEPARTMENT OF SURGERY
LEBANON NH
03756-1000
US

V. Phone/Fax

Practice location:
  • Phone: 603-650-4682
  • Fax: 603-650-4973
Mailing address:
  • Phone: 603-650-4682
  • Fax: 603-650-4973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number203033
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2006-01219
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: