Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | MD21392 | ME |
NPI | 1003254178 |
---|---|
Provider Name | Katharine M K Anderson |
First Address | Augusta, ME 04330-5736 |
Second Address | Augusta, ME 04330-5736 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2013 |
Last Update Date | 02/11/2016 |