Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 2623 | ME |
NPI | 1255404836 |
---|---|
Provider Name | Paul L Auclair |
First Address | South Portland, ME 04106-3266 |
Second Address | Portland, ME 04102-3134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2006 |
Last Update Date | 28/07/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0007450055 | AETNA (01) | ME |
036983 | ANTHEM (01) | ME |
2323308 | AETNA USHC (01) | ME |
3031852 | (05) | NH |
99002299 | (05) | ME |
M148551 | CIGNA (01) | ME |
U73557 | (02) | ME |
U73557 | HPHC (01) | ME |