Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | MD19243 | ME |
NPI | 1003041708 |
---|---|
Provider Name | James Hildebrand |
First Address | Bangor, ME 04401-3979 |
Second Address | Bangor, ME 04401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2009 |
Last Update Date | 15/08/2018 |