Individual
SUNDARAVADIVEL LOGANATHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
789 CENTRAL AVE, DOVER, NH 03820-2526
(603) 740-2503
(603) 740-2497
Mailing address
789 CENTRAL AVE, DOVER, NH 03820-2526
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19532
NH
207R00000X
Internal Medicine Physician
267908
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3118203
—
NH
Enumeration date
07/29/2016
Last updated
08/27/2019
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