Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | MD18898 | ME |
NPI | 1083824106 |
---|---|
Provider Name | Dr. Cameron Lee Trubey |
First Address | Bangor, ME 04401-2652 |
Second Address | Bangor, ME 04401-2652 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 16/07/2021 |