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General NPI Number Information
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NPI Number | 1518966027
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Entity Type | Individual
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Provider Name | STANLEY L WHITTEMORE JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/18/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 110 BROADWAY BUCKSPORT REGIONAL HEALTHCENTER
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City | BUCKSPORT
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State | ME
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Zip | 04416
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Country | US
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Telephone | 207-469-7371
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Fax | 207-469-7306
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Provider Business Mailing Address
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Address Line | 110 BROADWAY
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City | BUCKSPORT
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State | ME
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Zip | 04416
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Country | US
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Telephone | 207-469-7371
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Fax | 207-469-7306
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD00017552
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD19942
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License Number State | ME
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