Individual
NICOLE J SMITH-SANDILANDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
242 BRUNSWICK ST, OLD TOWN, ME 04468-1613
(207) 827-6128
Mailing address
PO BOX 1599, BANGOR, ME 04402-1599
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD18267
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113650708
TAX ID
—
05
—
434719099
—
ME
Enumeration date
12/01/2006
Last updated
05/05/2021
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