Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 010516 | ME |
NPI | 1083691869 |
---|---|
Provider Name | Robin M Wood |
First Address | Lewiston, ME 04241-1849 |
Second Address | Waterville, ME 04901-4974 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2005 |
Last Update Date | 20/03/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C66306 | (02) |