Healthcare Provider Details

I. General information

NPI: 1073500807
Provider Name (Legal Business Name): ROBERT W. NUTTING R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

Provider Other Name: ROBERT W. NUTTING R.PH.

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 TOWN FARM RD BOX 100
OAKLAND ME
04963-4209
US

IV. Provider business mailing address

430 TOWN FARM RD P.O.BOX 100
OAKLAND ME
04963-4209
US

V. Phone/Fax

Practice location:
  • Phone: 207-465-7139
  • Fax:
Mailing address:
  • Phone: 207-465-7139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPR2892
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: