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General NPI Number Information
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NPI Number | 1487837894
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Entity Type | Organization
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Legal Business Name | ALLAN W NYMAN DPM PA
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Dates
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Enumeration Date | 12/07/2007
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Last Update Date | 12/07/2007
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Provider Practice Location Address
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Address Line | 316 MAIN ST
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City | WATERVILLE
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State | ME
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Zip | 04901-4921
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Country | US
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Telephone | 207-873-2683
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Fax |
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Provider Business Mailing Address
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Address Line | 316 MAIN ST
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City | WATERVILLE
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State | ME
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Zip | 04901-4921
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Country | US
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Telephone | 207-873-2683
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALLAN W NYMAN
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Credential | DPM PA
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Telephone | 207-873-2683
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | POD136
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License Number State | ME
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