Doctor Name: | MR. THOMAS G POULIN |
NPI Number: | 1598803553 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | ALLS 1790 |
Business Practice Address: | 199 Cedar St Bangor, ME - 044014638 |
Business Phone Number: | 2079445501 |
Business Fax Number: | |
Mailing Address: | Po Box 217, BANGOR |
State: | ME |
Postal Code: | 044020217 |
Phone Number: | 2079905001 |
Fax Number: | |
NPI Enumeration Date: | 02/02/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | ALLS 1790 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |