Healthcare Provider Details

I. General information

NPI: 1588625602
Provider Name (Legal Business Name): HOWARD A SLEEPER OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 02/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 MONUMENT SQUARE LN
DOVER FOXCROFT ME
04426
US

IV. Provider business mailing address

5 MONUMENT SQUARE LN
DOVER FOXCROFT ME
04426
US

V. Phone/Fax

Practice location:
  • Phone: 207-564-2020
  • Fax: 207-564-2023
Mailing address:
  • Phone: 207-564-2020
  • Fax: 207-564-2023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberOPT574
License Number StateME

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierMNT569
Identifier TypeOTHER
Identifier StateME
Identifier IssuerHARVARD PILGRIM
# 2
Identifier005059
Identifier TypeOTHER
Identifier State
Identifier IssuerANTHEM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: