Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 015596 | ME |
NPI | 1003805995 |
---|---|
Provider Name | Dr. Martin D Whitaker |
First Address | Norway, ME 04268-5645 |
Second Address | Norway, ME 04268-5645 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2005 |
Last Update Date | 28/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
061139 | ANTHEM BLUE CROSS (01) | ME |
325120099 | (05) | ME |
3739577 | AETNA (01) | ME |
431545400 | (05) | ME |
M2307901 | CIGNA (01) | ME |
P00184354 | RAILROAD MEDICARE (01) | ME |