Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 018741 | ME |
Y | 208600000X | Surgeon | 018741 | ME |
N | 208200000X | Surgeon | TN38369 | TN |
N | 208600000X | Surgeon | TN38369 | TN |
N | 2082S0105X | Plastic Hand Surgeon | TN 38369 | TN |
NPI | 1871574715 |
---|---|
Provider Name | Mr. Charles E Foley |
First Address | Lewiston, ME 04240-7054 |
Second Address | Lewiston, ME 04240-7054 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2005 |
Last Update Date | 06/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3881416 | (05) | TN |
H91187 | (02) |