Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 254472 | MA |
N | 207V00000X | Obstetrician & Gynecologist | MD20685 | ME |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | MD20685 | ME |
NPI | 1669606521 |
---|---|
Provider Name | Caroline Foust-Wright |
First Address | South Portland, ME 04106-1999 |
Second Address | South Portland, ME 04106-6914 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2009 |
Last Update Date | 13/09/2016 |