Individual
DR. MACARIO F. LICHAUCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
489 STATE ST, KELLY 6 EASTERN MAINE MEDICAL CENTER, BANGOR, ME 04401-6616
(207) 973-8670
(207) 973-5163
Mailing address
489 STATE ST, KELLY 6 EASTERN MAINE MEDICAL CENTER, BANGOR, ME 04401-6616
(207) 973-8670
(207) 973-5163
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
35149711
OH
2080N0001X
Neonatal-Perinatal Medicine Physician
015508
ME
208M00000X
Hospitalist Physician
Primary
35149711
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0033779
—
OH
Enumeration date
06/28/2006
Last updated
12/20/2023
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