Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 017122 | ME |
NPI | 1023063518 |
---|---|
Provider Name | James A Stevenson |
First Address | Belfast, ME 04915-6009 |
Second Address | Belfast, ME 04915-6009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 07/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100478 | ANTHEM BLUE CROSS (01) | ME |
432221099 | (05) | ME |
F91255 | (02) | ME |