Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208G00000X | Cardiothoracic Vascular Surgeon | 0101246909 | VA |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 19850 | ME |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 26248 | OR |
N | 208G00000X | Cardiothoracic Vascular Surgeon | MD2011-0212 | NM |
NPI | 1063486371 |
---|---|
Provider Name | Dr. Flavian Mark Lupinetti |
First Address | Brewer, ME 04412-1005 |
Second Address | Bangor, ME 04401-6630 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 08/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1023732750001 | (05) | PA |
A14578 | (02) | AZ |