Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 015663 | ME |
NPI | 1801870506 |
---|---|
Provider Name | Dr. Michael Makaretz |
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 | 06/12/2005 |
Last Update Date | 07/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002413 | ANTHEM BLUE SHIELD (01) | ME |
040016217 | RAILROAD INDIV PROV # (01) | ME |
100224700 | DEPARTMENT OF LABOR (01) | ME |
110570000 | (05) | ME |
110570100 | (05) | ME |
2628379 | AETNA (01) | ME |
276630099 | (05) | ME |
9480962 | CIGNA INDIV PROV NUMBER (01) | ME |
A66548 | (02) | ME |
CH8191 | RAILROAD MCARE GROUP # (01) | ME |
M2995 | CIGNA NEW HAMPSHIRE (01) | ME |
MN4436 | HARVARD PILGIRM (01) | ME |