Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | MD23687 | ME |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | MD23687 | ME |
NPI | 1760820385 |
---|---|
Provider Name | John Ogorek |
First Address | Portland, ME 04102-3175 |
Second Address | Portland, ME 04106-1999 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2013 |
Last Update Date | 11/08/2020 |