Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | G077850 | CA |
N | 208600000X | Surgeon | G077850 | CA |
N | 2086S0102X | Surgical Critical Care | G077850 | CA |
Y | 2086S0102X | Surgical Critical Care | MD444587 | PA |
N | 2086S0127X | Trauma Surgeon | G077850 | CA |
NPI | 1306818570 |
---|---|
Provider Name | Joseph Frederick Rappold |
First Address | Scarborough, ME 04074-9701 |
Second Address | Portland, ME 04102-3100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2006 |
Last Update Date | 09/06/2015 |