Healthcare Provider Details

I. General information

NPI: 1750339198
Provider Name (Legal Business Name): ANDREW B CAREY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

287 MAIN ST SUITE 402
LEWISTON ME
04240-7054
US

IV. Provider business mailing address

PO BOX 1747
LEWISTON ME
04241-1747
US

V. Phone/Fax

Practice location:
  • Phone: 207-782-2420
  • Fax:
Mailing address:
  • Phone: 207-782-2492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number014180
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: