Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | MD12723 | ME |
NPI | 1063443836 |
---|---|
Provider Name | Michael G Pinette |
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 | 06/07/2006 |
Last Update Date | 26/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
251560099 | (05) | ME |
30003395 | (05) | NH |
B84117 | (02) |