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Individual

DR. MADELYNN AZAR-CAVANAGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD, MPH, CPE, FACOEM

Contact information

Practice address
ONE MEDICAL CENTER DRIVE, DARTMOUTH HITCHCOCK - OCCUPATIONAL MEDICINE, LEBANON, NH 03756
(603) 653-3893
Mailing address
24 BRADFORD ST APT 2, BOSTON, MA 02118-2119
(646) 799-8944

Taxonomy

Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
272637
NY
2083X0100X
Occupational Medicine Physician
Primary
LT4099
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
272537-1
STATE OF NEW YORK PHYSICIAN LICENSE
NY
01
60134
STATE OF MASSACHUSETTS PHYSICIAN LICENCE
MA
01
G64777
STATE OF CALIFORNIA PHYSICIAN LICENSE
CA
01
LT-4099
STATE OF NEW HAMPSHIRE LOCUM TENENS LICENSE
NH
Enumeration date
01/31/2007
Last updated
07/01/2019
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