Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | MD24132 | ME |
NPI | 1003159559 |
---|---|
Provider Name | Dr. Theodore William James |
First Address | Brewer, ME 04412-1006 |
Second Address | Bangor, ME 04401-6630 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2013 |
Last Update Date | 27/01/2021 |