Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD17823 | ME |
NPI | 1073724381 |
---|---|
Provider Name | Dr. Matthew James Hearst |
First Address | Portland, ME 04101-1823 |
Second Address | Portland, ME 04101-1823 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2007 |
Last Update Date | 22/10/2018 |