Healthcare Provider Details
I. General information
NPI: 1326012170
Provider Name (Legal Business Name): ANDREW C RICE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/16/2006
Last Update Date: 10/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4 SHERIDAN RD MAINE DARTMOUTH FAMILY PRACTICE
FAIRFIELD ME
04937-3314
US
IV. Provider business mailing address
4 SHERIDAN RD MAINE DARTMOUTH FAMILY PRACTICE
FAIRFIELD ME
04937-3314
US
V. Phone/Fax
- Phone: 207-861-5000
- Fax: 207-861-5001
- Phone: 207-861-5000
- Fax: 207-861-5001
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 016646 |
| License Number State | ME |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: