Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 005653 | ME |
NPI | 1033246731 |
---|---|
Provider Name | Dr. Alan Woodford Boone |
First Address | Bangor, ME 04401-5520 |
Second Address | Bangor, ME 04401-5520 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2007 |
Last Update Date | 08/07/2007 |