Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 3237 | ME |
NPI | 1053974626 |
---|---|
Provider Name | Michael William Cameron |
First Address | Damariscotta, ME 04543-4047 |
Second Address | Damariscotta, ME 04543-4047 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2019 |
Last Update Date | 18/04/2019 |