Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 011732 | ME |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 011732 | ME |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 011732 | ME |
NPI | 1164410858 |
---|---|
Provider Name | Richard Reed Gramse |
First Address | Portland, ME 04102-2102 |
Second Address | Portland, ME 04102-2102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
018188 | ANTHEM (01) | ME |
1044464 | AETNA (01) | ME |
D03695 | (02) | |
M3900 | CIGNA (01) | ME |