Individual
RYAN M HOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
216 MAIN STREET, WATERVILLE, ME 04901
(207) 872-2797
(207) 872-2793
Mailing address
PO BOX 1438, WATERVILLE, ME 04903
(207) 872-2797
(207) 872-2793
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT878
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061399
ANTHEM
ME
Enumeration date
08/31/2006
Last updated
07/08/2007
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