Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 962 | ME |
NPI | 1417932013 |
---|---|
Provider Name | Dr. Martha Friberg |
First Address | Portland, ME 04101-1823 |
Second Address | Portland, ME 04101-1823 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2005 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002296 | ANTHEM BLUE SHIELD (01) | ME |
040924 | ANTHEM BLUE SHIELD (01) | ME |
2427080 | AETNA (01) | ME |
2727288 | CIGNA INDIV PROV # (01) | ME |
CH8191 | RAILROAD MCARE GROUP # (01) | ME |
D93074 | (02) | ME |
M2672 | NEWHAMPSHIRE CIGNA (01) | NH |