Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | MD21509 | ME |
NPI | 1386727782 |
---|---|
Provider Name | Dr. Whitney James Mcbride |
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 | 23/10/2006 |
Last Update Date | 26/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02202922 | (05) | NY |
CC9585 | (02) |