Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 278749 | MA |
N | 111NI0900X | Internist | 278749 | MA |
Y | 207RA0401X | Internist - Addiction Medicine | MD23845 | ME |
NPI | 1316393093 |
---|---|
Provider Name | David Kispert |
First Address | Biddeford, ME 04005-2411 |
Second Address | Biddeford, ME 04005-2411 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2016 |
Last Update Date | 25/06/2020 |