Provider Demographics
NPI:1891101374
Name:PATWARDHAN, SOUMIL SHRIHARI (MD)
Entity Type:Individual
Prefix:
First Name:SOUMIL
Middle Name:SHRIHARI
Last Name:PATWARDHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 CLARK WAY
Mailing Address - Street 2:
Mailing Address - City:SOMERSWORTH
Mailing Address - State:NH
Mailing Address - Zip Code:03878-4401
Mailing Address - Country:US
Mailing Address - Phone:603-692-2228
Mailing Address - Fax:603-692-4748
Practice Address - Street 1:330 BORTHWICK AVE STE 311
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-7112
Practice Address - Country:US
Practice Address - Phone:603-692-2228
Practice Address - Fax:603-692-4748
Is Sole Proprietor?:No
Enumeration Date:2014-07-07
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD26901207RG0100X
WAMD60992946207RG0100X
NH24002207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology