Individual
DONALD RENE CARBONNEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
313 WATER ST, AUGUSTA, ME 04330-4619
(207) 623-8622
Mailing address
313 WATER ST, AUGUSTA, ME 04330-4619
(207) 623-8622
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT732
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000749
ANTHEM
ME
Enumeration date
02/28/2007
Last updated
02/27/2008
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