Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 1869 | ME |
NPI | 1376614842 |
---|---|
Provider Name | Liane M Muller |
First Address | Bridgton, ME 04009 |
Second Address | Bridgton, ME 04009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 26/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
079115 | ANTHEM (01) | ME |
099629 | BCBS (01) | ME |
1127587 | AETNA (01) | ME |
133516 | HARV PILGRIM (01) | ME |
431995900 | (05) | ME |
5488624 | CIGNA (01) | ME |
I33516 | (02) | |
ME1384 | (02) | ME |