Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 016721 | ME |
Y | 207ND0101X | MOHS-Micrographic Surgeon | 016721 | ME |
NPI | 1063451896 |
---|---|
Provider Name | Dr. Carrine A. Burns |
First Address | Lewiston, ME 04240-7792 |
Second Address | Lewiston, ME 04240-7792 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 29/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
431783899 | (05) | ME |
I40527 | (02) | ME |