Individual
FRED SIMS STUCKY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
35 MEDICAL CENTER PKWY, AUGUSTA, ME 04330-8160
(207) 621-4680
Mailing address
35 MEDICAL CENTER PKWY, AUGUSTA, ME 04330-8160
(207) 621-4680
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
00017567
AL
2086S0129X
Vascular Surgery Physician
Primary
MD27794
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051514735
—
AL
05
—
126147
—
AL
01
—
511-11831
BCBS-AL
AL
01
—
51514735STU
BLUE CROSS BLUE SHIELD
AL
01
—
P00000016
MEDICARE RAILROAD
AL
Enumeration date
05/25/2006
Last updated
06/25/2024
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