Cantwell Clark V, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

12598 Issued in NH

Practice address

Dartmouth-Hitchcock Clinic
1 Medical Center Drive
Lebanon, NH 03756

Phone

(603) 650-5922

NPI assigned

Oct 6, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311724800000",
    "number": "1376630541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "DHMC. DEPARTMENT OF ANESTHESIOLOGY",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DARTMOUTH-HITCHCOCK CLINIC",
            "address_2": "1 MEDICAL CENTER DRIVE",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "03756",
            "telephone_number": "603-650-5922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CANTWELL",
        "name_prefix": "Dr.",
        "name_suffix": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2011-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NH",
            "license": "12598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011289",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30201138",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michaela Cioffredi, DPT
• Ruth Curtis Cioffredi, OT
• William J Cioffredi, PT
• City of Lebanon
• Robin R Clark-Arbogast, MS APRN
• James Kenneth Seffinga Clark, M.D.
• Jean A. Clark, RN, MS, CCRN, APRN
• Jeffrey Allen Clark, M.D.
• Jenna Clark, MD
• Kelly Fisher Clark, OT

• Anesthesiology Physician in Lebanon, NH
• Providers in Lebanon, NH by specialty
• Anesthesiology Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.