Healthcare Provider Details

I. General information

NPI: 1619131604
Provider Name (Legal Business Name): LANA SHIKHMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SVETLANA SHIKHMAN MD

II. Dates (important events)

Enumeration Date: 07/18/2008
Last Update Date: 07/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 QUEEN CITY AVE
MANCHESTER NH
03101-7121
US

IV. Provider business mailing address

185 QUEEN CITY AVE
MANCHESTER NH
03101-7121
US

V. Phone/Fax

Practice location:
  • Phone: 603-668-3067
  • Fax:
Mailing address:
  • Phone: 603-668-3067
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMT193952
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number254908
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number254908
License Number StateMA
# 4
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number16735
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: