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Individual
GORDON THOMPSON CALDWELL JR.
Active
Individual
GORDON THOMPSON CALDWELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
012721
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010424957
CHAMPUS
—
01
—
030495
BCBS
—
01
—
2075723
AETNA
—
01
—
25012128
MEDICARE RAILROAD
—
05
—
272410099
—
ME
01
—
E19633
HARVARD PILGRIM
—
01
—
M52001
CIGNA
—
Enumeration date
03/02/2006
Last updated
04/28/2011
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