Individual
DR. PAUL GABRIEL GOSSELIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
147 RIVERSIDE DRIVE, SUITE 1, AUGUSTA, ME 04330
(207) 623-6355
(207) 622-0853
Mailing address
147 RIVERSIDE DRIVE, SUITE 1, AUGUSTA, ME 04330
(207) 623-6355
(207) 622-0853
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
1631
ME
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
1631
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030622895
CHAMPUS
ME
05
—
175350000
—
ME
Enumeration date
06/22/2006
Last updated
08/26/2009
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