Healthcare Provider Details

I. General information

NPI: 1164862405
Provider Name (Legal Business Name): PRESTON D RINGO DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2013
Last Update Date: 01/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 CHAPMAN ST
DAMARISCOTTA ME
04543-4614
US

IV. Provider business mailing address

310 BATH RD
BRUNSWICK ME
04011-2771
US

V. Phone/Fax

Practice location:
  • Phone: 207-563-3233
  • Fax: 207-563-3201
Mailing address:
  • Phone: 207-725-4008
  • Fax: 207-725-5749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPOD1102
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: