Southworth, Michael

Southworth, Michael is an individual health care provider with primary practice located at 6 Healthcare Dr Ste 1 , Rochester NH 03867-4499. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Southworth, Michael can be contacted via phone (603) 994-6400.

Contact Information

Primary practice address
6 Healthcare Dr Ste 1 Rochester NH 03867-4499
Phone: (603) 994-6400
Fax: (603) 994-6443
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 013160 Maine
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 8539 New Hampshire

Profile Details

NPI number 1306822481
LBN Legal business name Southworth, Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 20th, 2005
Last updated Jan 12th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306822481 NPPES
Other 0123485 AETNA
Other 020401332 AETNA
MEDICAID 30004276 AETNA
Other 008585 AETNA
MEDICAID 3073850 AETNA
MEDICAID 1306822481 AETNA
Other P00923460 AETNA
Other AA7682 AETNA
MEDICAID 299000099 AETNA
Other 0105960Y0NH01 AETNA

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