MEDICARE: DR. RICHARD DEBOWSKY M.D.

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	207L00000X	Anesthesiology Physician	014935	ME

General Provider Information

NPI Number	:	1588646038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD DEBOWSKY M.D.

Provider Business Mailing Address
First Line	:	400 6TH AVE N
Second Line	:
City	:	TIERRA VERDE
State	:	FL
Zip	:	33715-1815
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	140 ACADEMY ST
Second Line	:
City	:	PRESQUE ISLE
State	:	ME
Zip	:	04769-3180
Country	:	US
Telephone Number	:	207-768-4000
Fax Number	:

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

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	07/15/2011

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