MEDICARE: DR. DOUGLAS STUART COLE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	11761	ME

General Provider Information

NPI Number	:	1285621359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOUGLAS STUART COLE MD

Provider Business Mailing Address
First Line	:	4 GLEN COVE DR
Second Line	:	SUITE 103
City	:	ROCKPORT
State	:	ME
Zip	:	04856-4235
Country	:	US
Telephone Number	:	207-593-5737
Fax Number	:	207-593-5333

Provider Business Practice Location Address
First Line	:	4 GLEN COVE DR
Second Line	:	SUITE 201
City	:	ROCKPORT
State	:	ME
Zip	:	04856-4235
Country	:	US
Telephone Number	:	207-593-5703
Fax Number	:	207-593-5348

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	01/29/2013

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