Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 014334 | ME |
NPI | 1144296609 |
---|---|
Provider Name | Andrew A Hertler |
First Address | Augusta, ME 04330-8058 |
Second Address | Augusta, ME 04330-8058 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2006 |
Last Update Date | 13/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
324830099 | (05) | ME |
B65609 | (02) | ME |