Healthcare Provider Details

I. General information

NPI: 1942104989
Provider Name (Legal Business Name): COLBY HUNTER POMEROY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 EASTERN AVE
AUGUSTA ME
04330-5829
US

IV. Provider business mailing address

66 EASTERN AVE
AUGUSTA ME
04330-5829
US

V. Phone/Fax

Practice location:
  • Phone: 207-620-8291
  • Fax: 207-620-8292
Mailing address:
  • Phone: 207-620-8291
  • Fax: 207-620-8292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberCI3168
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: