Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 013964 | ME |
NPI | 1235467580 |
---|---|
Provider Name | Arvind Patel |
First Address | Orono, ME 04473-3667 |
Second Address | Rockland, ME 04841 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2009 |
Last Update Date | 24/06/2010 |