MEDICARE: ANIL K DEWAN MD

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	14583	NH
2	207ZC0500X	Cytopathology Physician	0101239605	VA

General Provider Information

NPI Number	:	1992913032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANIL K DEWAN MD

Provider Business Mailing Address
First Line	:	1 HAMPTON ROAD
Second Line	:	SUITE 208
City	:	EXETER
State	:	NH
Zip	:	03833-4849
Country	:	US
Telephone Number	:	603-778-8522
Fax Number	:	603-778-1602

Provider Business Practice Location Address
First Line	:	1 HAMPTON ROAD
Second Line	:	SUITE 208
City	:	EXETER
State	:	NH
Zip	:	03833-4849
Country	:	US
Telephone Number	:	603-778-8522
Fax Number	:	603-778-1602

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

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	11/20/2009

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