Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 016241 | ME |
NPI | 1295799500 |
---|---|
Provider Name | Dr. Barry Hugo |
First Address | Biddeford, ME 04005-3747 |
Second Address | Kennebunk, ME 04043-6601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
048516 | ANTHEM (01) | LA |
3615048 | AETNA (01) | ME |
8254567 | CIGNA (01) | ME |
AA21113 | HARVARD PILGRIM (01) | ME |