Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 016266 | ME |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | MD016266 | ME |
NPI | 1790896256 |
---|---|
Provider Name | Melissa J Streeter |
First Address | Brunswick, ME 04011-2653 |
Second Address | Brunswick, ME 04011-2653 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 12/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H96454 | (02) | ME |