Individual
DR. TIMOTHY J GAGNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
149 NORTH ST, WATERVILLE, ME 04901-4974
(207) 872-1000
Mailing address
149 NORTH ST, WATERVILLE, ME 04901-4974
(207) 872-1000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD18415
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
435779099
—
ME
Enumeration date
07/12/2007
Last updated
08/11/2015
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