Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD14031 | ME |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | MD14031 | ME |
NPI | 1053313395 |
---|---|
Provider Name | Dr. Gregory C Pomeroy |
First Address | Lewiston, ME 04243-7291 |
Second Address | Portland, ME 04103-6003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2005 |
Last Update Date | 17/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
018062 | ANTHEM (01) | ME |
130350099 | (05) | ME |
1447226584-002 | (05) | ME |
200025975 | RAILROAD MEDICARE (01) | ME |
5720029 | AETNA (01) | ME |
G11180 | (02) | ME |