Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 013747 | ME |
Y | 2086S0105X | Surgery of the Hand | 013747 | ME |
NPI | 1447254115 |
---|---|
Provider Name | John I Pyne |
First Address | Bangor, ME 04401-2652 |
Second Address | Bangor, ME 04401-2652 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2005 |
Last Update Date | 16/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
011499 | ANTHEM (01) | |
09-01065 | UNITED HC (01) | |
1040724 | AETNA (01) | |
2000028936 | RR MEDICARE (01) | |
304280099 | (05) | ME |
F56188 | (02) | |
M67422 | CIGNA (01) | |
ME0560 | HP (01) |