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Individual

DR. WANE G JOSELOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
703 RIVERWAY PL, BEDFORD, NH 03110-6768
(603) 668-7096
(603) 669-6944
Mailing address
61 PINECREST RD, MANCHESTER, NH 03104-1666

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
7122
NH
2085R0202X
Diagnostic Radiology Physician
Primary
7122
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
007122
TUFTS
NH
01
0105455Y0 NH06
ANTHEM MCH TAX ID
NH
01
0105455Y0NH03
BLUE CROSS
NE
01
2176872
AETNA
NH
01
2781
CIGNA
NH
05
30001058
NH
Enumeration date
04/14/2006
Last updated
12/18/2023
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