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Individual

DR. DMITRY TARASEVICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
454 OLD STREET ROAD, SUITE 301, PETERBOROUGH, NH 03458-1263
(603) 924-4680
(603) 924-4977
Mailing address
454 OLD STREET ROAD, SUITE 301, PETERBOROUGH, NH 03458-1263
(603) 924-4680
(603) 924-4977

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
15050
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002051101
MEDICARE PTAN
NH
05
32000229
NH
Enumeration date
11/28/2007
Last updated
03/29/2021
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