Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | DO2297 | ME |
Y | 207Q00000X | Family Doctor | DO2297 | ME |
NPI | 1114161874 |
---|---|
Provider Name | Timothy Christopher Kulikowski |
First Address | Orono, ME 04473-3623 |
Second Address | Bangor, ME 04401-8603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2009 |
Last Update Date | 07/01/2022 |