Individual
STANISLAV SIDASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
ONE MEDICAL CENTER DRIVE, ANESTHESIOLOGY, LEBANON, NH 03756
(603) 650-5922
Mailing address
ONE MEDICAL CENTER DRIVE, ANESTHESIOLOGY, LEBANON, NH 03756-0001
(603) 650-5922
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
17536
NH
207L00000X
Anesthesiology Physician
271554
MA
207LP2900X
Pain Medicine (Anesthesiology) Physician
271554
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1027544
—
VT
05
—
110126498A
—
MA
05
—
3104528
—
NH
Enumeration date
04/24/2013
Last updated
06/28/2018
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