Individual
DR. TIMOTHY DEWITT CARNES JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17 BISHOP ST, PORTLAND, ME 04103-2659
(207) 835-0488
(207) 835-0359
Mailing address
17 BISHOP ST, PORTLAND, ME 04103-2659
(207) 835-0488
(207) 835-0359
Taxonomy
Speciality
Code
Description
License number
State
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
16503
ME
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
16503
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4144900099
—
ME
Enumeration date
01/19/2006
Last updated
04/27/2019
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