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1174516009

NPI Code Detail

MEDICARE: DAVID J SYREK M.D.

MEDICARE: DAVID J SYREK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	12084	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AA3494	OTHER		HARVARD HEALTH
2	01Y005220NH01	OTHER	NH	BC/BS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	467491	OTHER		TUFTS
5	0135502	OTHER		CIGNA

General Provider Information

NPI Number	:	1174516009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID J SYREK M.D.

Provider Business Mailing Address
First Line	:	PO BOX 24
Second Line	:
City	:	CANDIA
State	:	NH
Zip	:	03034-0024
Country	:	US
Telephone Number	:	603-483-2854
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 PROSPECT ST
Second Line	:	2ND FL
City	:	NASHUA
State	:	NH
Zip	:	03060-3921
Country	:	US
Telephone Number	:	603-889-4431
Fax Number	:	603-889-1572

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	07/08/2007

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Directions to “ DAVID J SYREK M.D.” Practice Location

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