Provider Demographics
NPI:1487742797
Name:HARLAND, DAWN LOUISE (MD)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:LOUISE
Last Name:HARLAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-3744
Mailing Address - Country:US
Mailing Address - Phone:603-354-5454
Mailing Address - Fax:603-352-5118
Practice Address - Street 1:24 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-3744
Practice Address - Country:US
Practice Address - Phone:603-354-5454
Practice Address - Fax:603-352-5118
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11060207R00000X, 2083A0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0RE5883Medicaid
NH30201074Medicaid
NHRE5883Medicare PIN
H23903Medicare UPIN