Healthcare Provider Details

I. General information

NPI: 1689651069
Provider Name (Legal Business Name): ROBERT D.E. RICE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 06/29/2020
Certification Date: 06/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

272 COTTAGE ST
SANFORD ME
04073-1815
US

IV. Provider business mailing address

272 COTTAGE ST
SANFORD ME
04073-1815
US

V. Phone/Fax

Practice location:
  • Phone: 207-324-1110
  • Fax: 207-636-5023
Mailing address:
  • Phone: 207-324-1110
  • Fax: 207-636-5023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number015113
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: