Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 232919 | MA |
Y | 2080P0214X | Pediatric Pulmonologist | MD19681 | ME |
NPI | 1043417116 |
---|---|
Provider Name | Anne C Coates |
First Address | Scarborough, ME 04074-9701 |
Second Address | Portlanad, ME 04102-3103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2007 |
Last Update Date | 25/10/2013 |