Provider Demographics
NPI:1407847528
Name:ATHANS, JOHN P (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:ATHANS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:7 WORKS WAY
Mailing Address - Street 2:
Mailing Address - City:SOMERSWORTH
Mailing Address - State:NH
Mailing Address - Zip Code:03878-1639
Mailing Address - Country:US
Mailing Address - Phone:603-841-2301
Mailing Address - Fax:603-692-1081
Practice Address - Street 1:255 ROUTE 108
Practice Address - Street 2:
Practice Address - City:SOMERSWORTH
Practice Address - State:NH
Practice Address - Zip Code:03878-1543
Practice Address - Country:US
Practice Address - Phone:603-841-2301
Practice Address - Fax:603-692-1081
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA43036207ZP0102X, 207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3111926Medicaid
CT001435066Medicaid
MA2110211Medicaid
MA2110211Medicaid
CT001435066Medicaid