Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | DO2631 | ME |
NPI | 1003027509 |
---|---|
Provider Name | Dr. Amanda Gail Querry |
First Address | Brewer, ME 04412-1006 |
Second Address | Bangor, ME 04401-6630 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2007 |
Last Update Date | 10/04/2020 |