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Contact Information

MICHAEL SOUTHWORTH, MD
789 CENTRAL AVE
DOVER, NH03820-2526
 Phone: 603-740-2832
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Vascular Surgery

2086S0129X 76 Physician/Peripheral Vascular Disease
Indicates primary specialty

NPI Profile & details for MICHAEL SOUTHWORTH · (Male)

NPI Number 1306822481
Status Active
Credentials MD
Entity Individual
Enumeration date 12/20/2005
Last updated 02/25/2026 - About 3 months ago
Sole proprietor 1 No
Identifiers
  • ME License # 013160
  • NH License # 8539
  • ME Medicaid 1306822481
  • ME Medicaid 299000099
  • NH Medicaid 30004276
  • NH Medicaid 3073850
  • Other 0123485 AETNA
  • Other 0105960Y0NH01 ANTHEM BLUE CROSS
  • Other AA7682 HARVARD PILGRIM
  • Other 008585 MAINE BLUE CROSS
  • Other 020401332 MARTINS POINT
  • NH Other P00923460 RAILROAD MEDICARE
Hospital affiliation(s)
  • MAINE MEDICAL CENTER - (Acute Care)
    22 BRAMHALL ST
    PORTLAND, ME 04102
  • SOUTHERN MAINE MEDICAL CENTER - (Acute Care)
    1 MEDICAL CENTER DRIVE
    BIDDEFORD, ME 04005
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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