Provider Demographics
NPI:1619960333
Name:RASLAVICIUS, POLIUS (MD)
Entity Type:Individual
Prefix:DR
First Name:POLIUS
Middle Name:
Last Name:RASLAVICIUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:PAUL
Other - Middle Name:
Other - Last Name:RASLAVICUS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:253 NORTH SHORE RD
Mailing Address - Street 2:
Mailing Address - City:NEW DURHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03855
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:789 CENTRAL AVE
Practice Address - Street 2:WENTWORTH-DOUGLASS HOSPITAL
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-2526
Practice Address - Country:US
Practice Address - Phone:603-335-2338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH5076207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology