Individual
MICHAEL SOUTHWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
789 CENTRAL AVE, DOVER, NH 03820-2526
(603) 740-2832
Mailing address
PO BOX 412503, BOSTON, MA 02241-2503
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
013160
ME
2086S0129X
Vascular Surgery Physician
Primary
8539
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008585
MAINE BLUE CROSS
—
01
—
0105960Y0NH01
ANTHEM BLUE CROSS
—
01
—
0123485
AETNA
—
01
—
020401332
MARTINS POINT
—
05
—
1306822481
—
ME
05
—
299000099
—
ME
05
—
30004276
—
NH
05
—
3073850
—
NH
01
—
AA7682
HARVARD PILGRIM
—
01
—
P00923460
RAILROAD MEDICARE
NH
Enumeration date
12/20/2005
Last updated
02/25/2026
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