=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396130332
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AARON LLOYD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/06/2015
-----------------------------------------------------
Last Update Date | 09/28/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 887 CONGRESS ST
-----------------------------------------------------
City | PORTLAND
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04102-3100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-774-6368
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8469 MEADOW VISTA DR
-----------------------------------------------------
City | LEWISVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27023-9872
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-736-8933
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207LC0200X
-----------------------------------------------------
Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
-----------------------------------------------------
License Number | MD23667
-----------------------------------------------------
License Number State | ME
-----------------------------------------------------