Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 012847 | ME |
NPI | 1013986033 |
---|---|
Provider Name | Robert Octave Westcot II |
First Address | Biddeford, ME 04005-9430 |
Second Address | Biddeford, ME 04005-9430 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 03/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
126680000 | (05) | ME |