Individual
ALVIN WYCOCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
163 VAN BUREN RD, CARIBOU, ME 04736-3567
(207) 498-3111
Mailing address
31464 POLO CREEK RD, TEMECULA, CA 92591-7411
(973) 757-3460
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD20530
ME
207R00000X
Internal Medicine Physician
ME114576
FL
207R00000X
Internal Medicine Physician
Q2633
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/19/2011
Last updated
07/21/2022
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