Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 016390 | ME |
NPI | 1083640163 |
---|---|
Provider Name | Dr. Amy J Movius |
First Address | Brewer, ME 04412-1005 |
Second Address | Bangor, ME 04401-6616 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 20/03/2008 |