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General NPI Number Information
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NPI Number | 1447254115
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Entity Type | Individual
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Provider Name | JOHN I PYNE MD
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Gender | Male
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 07/16/2021
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Provider Practice Location Address
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Address Line | 78 RIDGEWOOD DR
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City | BANGOR
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State | ME
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Zip | 04401-2652
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Country | US
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Telephone | 207-947-8381
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Fax | 207-947-6056
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Provider Business Mailing Address
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Address Line | 78 RIDGEWOOD DR
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City | BANGOR
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State | ME
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Zip | 04401-2652
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Country | US
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Telephone | 207-947-8381
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Fax | 207-947-6056
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 013747
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number | 013747
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License Number State | ME
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