Doctor Name: | DR. FRED JOHN LAGOMARSINO |
NPI Number: | 1972830594 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 006249 |
Business Practice Address: | 74 Sunset Shores Lane Belgrade, ME - 04917 |
Business Phone Number: | 9036542316 |
Business Fax Number: | 9038745269 |
Mailing Address: | Po Box 96, OAKLAND |
State: | ME |
Postal Code: | 049630096 |
Phone Number: | 9036542316 |
Fax Number: | 9038745269 |
NPI Enumeration Date: | 11/04/2009 |
NPI Last Update Date: | 11/04/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 006249 |
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. |