Individual
MR. DAVID THOMAS DOUGLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
955 BROADWAY, BANGOR, ME 04401-2918
(207) 990-4388
(207) 947-9241
Mailing address
955 BROADWAY, BANGOR, ME 04401-2918
(207) 990-4388
(207) 947-9241
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT757
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
243540099
—
ME
Enumeration date
08/15/2005
Last updated
01/16/2025
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