Healthcare Provider Details

I. General information

NPI: 1447513585
Provider Name (Legal Business Name): PAUL BENJAMIN GLOE III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2012
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

177 N MAIN ST
STRONG ME
04983-3005
US

IV. Provider business mailing address

PO BOX 727
WATERVILLE ME
04903-0727
US

V. Phone/Fax

Practice location:
  • Phone: 207-684-4010
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD60489211
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: