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Organization

WENTWORTH DOUGLASS PHYSICIAN CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOEL DEGENAARS (EXECUTIVE DIRECTOR OF FINANCE)
(603) 740-2806
Entity
Organization

Contact information

Practice address
789 CENTRAL AVE, DOVER, NH 03820-2526
(603) 742-5252
Mailing address
PO BOX 412503, BOSTON, MA 02241-2503

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
133V00000X
Registered Dietitian
207LP2900X
Pain Medicine (Anesthesiology) Physician
207Q00000X
Family Medicine Physician
NH
207RC0000X
Cardiovascular Disease Physician
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
207RH0003X
Hematology & Oncology Physician
207RI0200X
Infectious Disease Physician
207RP1001X
Pulmonary Disease Physician
207RR0500X
Rheumatology Physician
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
208M00000X
Hospitalist Physician
2471M1202X
Magnetic Resonance Imaging Radiologic Technologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3081002
NH
05
3084198
NH
05
3123060
NH
Enumeration date
09/01/2006
Last updated
12/17/2025
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