Individual
ERIC SCOTT DEANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3175
(207) 662-2801
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3175
(207) 662-2801
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PR5312
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PR5312
PHARMACIST LICENSE
ME
Enumeration date
08/14/2018
Last updated
08/14/2018
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