Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 3827 | ME |
Y | 213EG0000X | General Practice | 3827 | ME |
NPI | 1003932716 |
---|---|
Provider Name | Megan Jean Lucier |
First Address | Sanford, ME 04073-3574 |
Second Address | Sanford, ME 04073 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
113090000 | MAINE CARE (01) | ME |
432488100 | MAINE CARE (01) | ME |