Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 2213 | ME |
N | 207K00000X | Allergist & Immunologist | DO126145 | OR |
N | 207K00000X | Allergist & Immunologist | DO2213 | ME |
N | 207K00000X | Allergist & Immunologist | OP60094489 | WA |
N | 207KA0200X | Allergist | DO126145 | OR |
N | 207KA0200X | Allergist | OP60094489 | WA |
NPI | 1508807751 |
---|---|
Provider Name | Scott Allen Dyer |
First Address | Augusta, ME 04330-8160 |
Second Address | Augusta, ME 04330-8160 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 03/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1508807751 | (05) | ME |
H71129 | (02) |