Individual
DR. PRASHANTHI DIVAKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
(603) 650-5000
Mailing address
PO BOX 810, HANOVER, NH 03755-0810
(603) 308-1472
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
316733
NY
207Y00000X
Otolaryngology Physician
Primary
33070
NH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2017
Last updated
10/02/2024
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