Provider Demographics
NPI:1326485038
Name:DYSON, ERIC MICHAEL (DO)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:MICHAEL
Last Name:DYSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:246 PLEASANT ST.
Mailing Address - Street 2:MEMORIAL BUILDING, WEST, GROUND FLOOR
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2548
Mailing Address - Country:US
Mailing Address - Phone:603-415-6400
Mailing Address - Fax:603-227-7595
Practice Address - Street 1:246 PLEASANT ST
Practice Address - Street 2:MEMORIAL BUILDING, WEST, GROUND FLOOR
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2548
Practice Address - Country:US
Practice Address - Phone:603-415-6400
Practice Address - Fax:603-227-7595
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-04
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOTO15491208600000X
NH20710208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery