Individual
THOMAS ROLAND MAYCOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9 FAHEY ST, BELFAST, ME 04915-6028
(207) 338-1120
(207) 338-1691
Mailing address
9 FAHEY ST, BELFAST, ME 04915-6028
(207) 338-1120
(207) 338-1691
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
008970
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010430165
STANDARD INS
—
01
—
012002
ANTHEM
—
01
—
1041723
AETNA
—
05
—
118460000
—
ME
Enumeration date
08/16/2005
Last updated
06/07/2012
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