Dartmouth Medical School

Primary specialty

Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X

License

4476 Issued in NH

Legal business name

DARTMOUTH MEDICAL SCHOOL

Practice address

33 Rip Rd
Hanover, NH 03755-1616

Phone

(603) 643-2903

NPI assigned

Jul 12, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Wiley W. Souba, M.D.

Title

Dean

Phone

(603) 650-1200

Specialties & licenses 1

Addresses

Tax ID family

Dartmouth Hitchcock Psychiatric Associates5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Dartmouth Hitchcock Psychiatric Associates

  • Sleep Disorder Diagnostic Clinic/Center
  • Lebanon, NH
  • NPI 1073727665
  NPD tax ID
• Dartmouth Hitchcock Psychiatric Associates

  • General Acute Care Hospital
  • Lebanon, NH
  • NPI 1194030395
  NPD tax ID
• Trustees of Dartmouth College

  • Student Health Clinic/Center
  • Hanover, NH
  • NPI 1689705931
  NPD tax ID
• Trustess of Dartmouth College

  • Student Health Clinic/Center
  • Hanover, NH
  • NPI 1205271574
  NPD tax ID

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

{
    "created_epoch": "1342051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342051200000",
    "number": "1669737805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 RIP RD",
            "city": "HANOVER",
            "state": "NH",
            "postal_code": "037551616",
            "telephone_number": "603-643-2903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 RIP RD",
            "city": "HANOVER",
            "state": "NH",
            "postal_code": "037551616",
            "telephone_number": "603-643-2903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DARTMOUTH MEDICAL SCHOOL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-12",
        "last_updated": "2012-07-12",
        "status": "A",
        "authorized_official_last_name": "SOUBA",
        "authorized_official_first_name": "WILEY",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "DEAN",
        "authorized_official_telephone_number": "603-650-1200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "NH",
            "license": "4476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan H Dalen, LCMHC
• Daniel W. Collison MD PLLC
• Rebecca Sue Daniels, COTA
• Christine Darcy, D.O.
• Tracey J Darling, RDH
• Renee E Davis, LADC, LMHC
• Paul M Decker, DDS
• Deer Creek Psychological Associates, PA
• Christine Carney Demment, PH.D.
• Bryant D Denk, DDS

• Geriatric Psychiatry Physician in Hanover, NH
• Providers in Hanover, NH by specialty
• Geriatric Psychiatry Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2012; 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.