| NPI | 1336179084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND J LEADBETTER Practice Manager 207-474-6940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology |
| 207X00000X Orthopaedic Surgery | |
| 208000000X Pediatrics | |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| 208600000X Surgery | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2020-08-22 |