Individual
DR. STEPHEN LEWIS EBERSOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
168 EAST AVE, OPTOMETRIC ASSOCIATES, LEWISTON, ME 04240
(207) 784-3564
(207) 782-2541
Mailing address
168 EAST AVE, OPTOMERIC ASSOCIATES PA, LEWISTON, ME 04240-5626
(207) 784-3564
(207) 782-2541
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
832TA
ME
152W00000X
Optometrist
Primary
OPT832TA6
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
313250099
—
ME
Enumeration date
06/18/2006
Last updated
01/04/2011
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