Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 012032 | ME |
N | 208600000X | Surgeon | 012032 | ME |
N | 2082S0105X | Plastic Hand Surgeon | 012032 | ME |
NPI | 1376555904 |
---|---|
Provider Name | Mr. John A Attwood |
First Address | South Portland, ME 04106-2496 |
Second Address | South Portland, ME 04106-2496 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B86346 | (02) |