Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 01033852A | IN |
NPI | 1659397230 |
---|---|
Provider Name | Dr. Joshua Marc Careskey |
First Address | Bangor, ME 04401-6616 |
Second Address | Bangor, ME 04401-6616 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2006 |
Last Update Date | 02/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100242070 | (05) | IN |
F76634 | (02) |