IVAN ZADOUNAEV (NPI# 1316398506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316398506 |
| Entity Type | Individual |
| Full Name | IVAN ZADOUNAEV |
| Credential | M.D. |
| Practice Address |
59 Page Hill Rd Berlin NH 03570-3531 |
| Mailing Address |
1260 2nd Ave Se Cedar Rapids Medical Education Foundation Cedar Rapids IA 52403-4002 |
| Practice Telephone | 6037522200 |
| Practice Fax Number | 6033265831 |
| Mailing Telephone | 3192972300 |
| Mailing Fax Number | 3192972280 |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2019-05-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 19489 | NH | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | R-10727 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NH | NH LICENSE | 19489 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1201 3rd Ave Se, Eastern Iowa Health Center, Cedar Rapids, IA 524034009 | 3197307300 | 3197307368 |
| Street Address |
59 PAGE HILL RD |
| City | BERLIN |
| State | NH |
| Zip Code | 03570-3531 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871595876 | Susan Lessard | Nurse Practitioner | 59 Page Hill Rd, Berlin, NH 03570-3531 | 2005-08-10 |
| 1003438029 | Shannon Haley Frye | Audiologist | 59 Page Hill Rd, Berlin, NH 03570-3542 | 2020-05-13 |
| 1982230108 | Meredith Warren | Physical Therapist | 59 Page Hill Rd, Berlin, NH 03570-3531 | 2020-03-19 |
| 1699325472 | Coos North Country Radiology P.l.l.c. | Radiology | 59 Page Hill Rd, Berlin, NH 03570-3531 | 2019-09-13 |
| 1144719683 | Jonathan Michael Campbell | Audiologist | 59 Page Hill Rd, Berlin, NH 03570-3542 | 2018-05-09 |
| 1538697719 | Laurel Ashley Elkin | Emergency Medical Technician, Basic | 59 Page Hill Rd, Berlin, NH 03570-3531 | 2017-05-31 |
| 1366836082 | Tiffani Witmon | Otolaryngology | 59 Page Hill Rd, Berlin, NH 03570-3531 | 2015-03-19 |
| 1104229129 | Luc G Corriveau | Nurse Anesthetist, Certified Registered | 59 Page Hill Rd, Berlin, NH 03570 | 2014-10-04 |
| 1700218229 | Androscoggin Valley Hospital, Inc | Clinic/Center | 59 Page Hill Rd, Berlin, NH 03570-3531 | 2013-08-07 |
| 1114359635 | Androscoggin Valley Hospital, Inc | Clinical Medical Laboratory | 59 Page Hill Rd, Berlin, NH 03570-3531 | 2013-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093351991 | Debra Chen | Psychologist | 1 Success Loop Road, Berlin, NH 03570 | 2019-11-26 |
| 1669826780 | Tri County Community Action Program | Case Management | 30 Exchange St, Berlin, NH 03570 | 2016-04-14 |
| 1952789265 | Brianne Teaboldt | Family Medicine | 133 Pleasant St Unit 2, Berlin, NH 03570 | 2015-05-07 |
| 1932435286 | Kristy May Nadeau | Nutritionist | 457 Forbush Avenue, Berlin, NH 03570 | 2009-10-21 |
| 1477737195 | Gayle M Theberge | Student in an Organized Health Care Education/Training Program | 3 Twelfth Street, Berlin, NH 03570 | 2007-12-18 |
| 1003019837 | Coos County Family Health Services | Dentist | 73 Main Street, Berlin, NH 03570 | 2007-06-08 |
| 1598824658 | Saadat U Khan Md Pa | Internal Medicine | 213 High St, Saadat U Khan Md Prof Assn, Berlin, NH 03570 | 2006-12-06 |
| 1508956327 | Judy Marie E Buteau | Social Worker | 292 Pleasant Street, Berlin, NH 03570 | 2006-10-13 |
| 1538254024 | Laurel J Pulsifer | Optometrist | 820 Main Street, Berlin, NH 03570 | 2006-10-03 |
| 1760592778 | William D Foord | Ophthalmology | 60 Pleasant St, Berlin, NH 03570 | 2006-08-30 |
| Find all providers in zip 03570 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093179400 | Justin Cherng Chuang | Family Medicine | Cvmc Hospitalist Department, 130 Fisher Road, 3rd Floor, Berlin, VT 05602-9000 | 2016-04-12 |
| 1952789265 | Brianne Teaboldt | Family Medicine | 133 Pleasant St Unit 2, Berlin, NH 03570 | 2015-05-07 |
| 1841587839 | Brian L Rodriguez | Family Medicine | 130 Fisher Rd., Ste. #3-1, Fahc-berlin Family Practice, Berlin, VT 05602 | 2011-06-29 |
| 1134428105 | Community Health Network | Family Medicine | W832 State Road 91, Ste 3, Berlin, WI 54923-8821 | 2011-03-16 |
| 1801038260 | Peninsula Regional Medical Center | Family Medicine | 10445 Ocean City Blvd, Unit #1, Berlin, MD 21811 | 2009-04-01 |
| 1306016050 | Atco Family Medical Associates, PC | Family Medicine | 10 Gardens Avenue, Berlin, NJ 08009-2104 | 2008-03-10 |
| 1336325596 | Jill E. Moorcroft | Family Medicine | 279 New Britain Rd, #6, Origins of Health, LLC, Berlin, CT 06037 | 2008-01-17 |
| 1902087190 | Richard Andrews Crandall IIi | Family Medicine | 1093 Brookfield Rd, Berlin, VT 05602-9065 | 2007-11-16 |
| 1174635536 | Angela L Gibbs | Family Medicine | 11200 Racetrack Rd, Ste A104, Berlin, MD 21811-3809 | 2006-08-31 |
| 1053347708 | Jennifer Brennan Bamford | Family Medicine | 130 Fisher Rd., Uvm Medical Center - Fm/berlin, Berlin, VT 05602 | 2006-06-24 |
| Find all providers in BERLIN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.