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Individual

SHINYA AMANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-0111
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
278298
MA
207N00000X
Dermatology Physician
Primary
MD23729
ME
207ND0900X
Dermatopathology Physician
MD23729
ME
207ZD0900X
Dermatopathology (Pathology) Physician
MD23729
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1184006108
ME
Enumeration date
06/25/2015
Last updated
07/02/2020
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