Healthcare Provider Details

I. General information

NPI: 1093702680
Provider Name (Legal Business Name): HUGH D MCGOWAN II M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 01/16/2024
Certification Date: 12/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 HOSPITAL DR STE C
YORK ME
03909-1041
US

IV. Provider business mailing address

298 YORK ST UNIT 12
YORK ME
03909-1074
US

V. Phone/Fax

Practice location:
  • Phone: 207-351-3455
  • Fax:
Mailing address:
  • Phone: 207-314-3734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number015775
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: