Healthcare Provider Details

I. General information

NPI: 1972634723
Provider Name (Legal Business Name): ROBIN E.D. ILLIAN C.P.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROBIN E. DOOLITTLE C.P.M.

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 02/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 RIVER RD
LIMINGTON ME
04049-3709
US

IV. Provider business mailing address

33 EDGEWORTH AVE
PORTLAND ME
04103-2411
US

V. Phone/Fax

Practice location:
  • Phone: 207-233-6888
  • Fax: 207-591-4767
Mailing address:
  • Phone: 207-233-6888
  • Fax: 207-591-4767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: