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Individual

JONATHAN L GASPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
149 MAIN ST, STE 2A, WINTHROP, ME 04364-1486
(207) 624-3800
(207) 624-3845
Mailing address
149 MAIN ST, STE 2A, WINTHROP, ME 04364-1486
(207) 624-3800
(207) 624-3845

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
018626
ME
207Q00000X
Family Medicine Physician
9601152
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5904978
NC
Enumeration date
07/10/2006
Last updated
10/16/2012
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