Provider Demographics
NPI:1952490591
Name:DEYOUNG, ANNA M (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:M
Last Name:DEYOUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANNA
Other - Middle Name:M
Other - Last Name:DEYOUNG-OWENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:700 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-3408
Mailing Address - Country:US
Mailing Address - Phone:603-742-2424
Mailing Address - Fax:603-742-1763
Practice Address - Street 1:700 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-3408
Practice Address - Country:US
Practice Address - Phone:603-742-2424
Practice Address - Fax:603-742-1763
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11365207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30009621Medicaid
G31966Medicare UPIN
RE6406Medicare ID - Type Unspecified