Individual
PETER A BEAUBOEUF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
15 WINNERS CIR, SUITE 2, TOPSHAM, ME 04086-1740
(207) 406-4635
(207) 406-4627
Mailing address
15 WINNERS CIR, SUITE 2, TOPSHAM, ME 04086-1740
(207) 406-4635
(207) 406-4627
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT879
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016356
ANTHEM BCBS
ME
05
—
431824199
—
ME
01
—
ME 133201
PTAN ME
—
Enumeration date
07/08/2005
Last updated
05/10/2013
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