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Individual

PAUL N SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12 STILLWATER AVE, BANGOR, ME 04401-3984
(207) 945-6588
(207) 945-2955
Mailing address
12 STILLWATER AVE, BANGOR, ME 04401-3984
(207) 945-6588
(207) 945-2955

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
016277
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0004661923
AETNA
ME
01
020706512
IRS TAXPAYER ID NUMBER
ME
01
060976
ANTHEM BLUE SHIELD
ME
05
2285200099
ME
Enumeration date
07/11/2006
Last updated
02/28/2013
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