Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | POD167 | ME |
NPI | 1063595817 |
---|---|
Provider Name | Richard Steinmetz |
First Address | Portland, ME 04103-3357 |
Second Address | Portland, ME 04103-3357 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 30/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
166830001 | (05) | ME |
T31436 | (02) |