Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | DO3198 | ME |
NPI | 1700314424 |
---|---|
Provider Name | Himanshu Malhotra |
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 | 25/05/2017 |
Last Update Date | 08/07/2021 |