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NPI Code Detail

MEDICARE: MICHAEL DOUGAN

MEDICARE: MICHAEL DOUGAN
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
1183500000XPharmacistPR12979ME

General Provider Information

NPI Number : 1720417033
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL DOUGAN
Provider Business Mailing Address
First Line : 11 STATE RD
Second Line :
City : BATH
State : ME
Zip : 04530-6014
Country : US
Telephone Number : 207-443-1786
Fax Number : 207-442-6706
Provider Business Practice Location Address
First Line : 11 STATE RD
Second Line :
City : BATH
State : ME
Zip : 04530-6014
Country : US
Telephone Number : 207-443-1786
Fax Number : 207-442-6706
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2013
Last Update Date : 11/06/2013

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Directions to “ MICHAEL DOUGAN ” Practice Location

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