Provider Demographics
NPI:1528148731
Name:DWYER, PATRICK JOSEPH (DPM)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:JOSEPH
Last Name:DWYER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 CONSTITUTION DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6076
Mailing Address - Country:US
Mailing Address - Phone:603-471-9933
Mailing Address - Fax:603-471-9944
Practice Address - Street 1:18 CONSTITUTION DR
Practice Address - Street 2:SUITE 2
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6076
Practice Address - Country:US
Practice Address - Phone:603-471-9933
Practice Address - Fax:603-471-9944
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0211213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30011061Medicaid
NH480014148OtherMEDICARE RAILROAD
NH30010840Medicaid
NHT25866Medicare UPIN
NH30011061Medicaid
NH30010840Medicaid
NH0551660001Medicare NSC