Provider Demographics
NPI:1942316104
Name:ZWAAN, ANTHONY CORNELIS (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:CORNELIS
Last Name:ZWAAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:19 HAMPTON RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-4816
Mailing Address - Country:US
Mailing Address - Phone:603-773-2225
Mailing Address - Fax:603-658-3105
Practice Address - Street 1:19 HAMPTON RD
Practice Address - Street 2:SUITE 1
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-4816
Practice Address - Country:US
Practice Address - Phone:603-773-2225
Practice Address - Fax:603-658-3105
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH10069207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30010658Medicaid
NH30010658Medicaid
RE4595Medicare ID - Type Unspecified