Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QG0300X | Family Doctor - Geriatric Medicine | 013508 | ME |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 013508 | ME |
NPI | 1497721930 |
---|---|
Provider Name | Elizabeth B Hart |
First Address | Lewiston, ME 04240-5941 |
Second Address | Lewiston, ME 04240-5941 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2006 |
Last Update Date | 21/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
311490099 | (05) | ME |
F53853 | (02) | ME |