David Brackett
Individual provider Active NPI Specialist · Westbrook, ME
NPI 1891939484 · NPPES record last updated Apr 27, 2009
Key facts
- NPI
- 1891939484
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- MT2129 (ME)
- Practice address
- 300 Main St
Westbrook, ME 04092-4715 - Phone
- (207) 807-1692
- Fax
- (207) 591-5108
- NPI assigned
- Apr 27, 2009
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT2129 | ME | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MT2129 | ME | Yes |
Addresses
Primary practice location
300 Main St
Westbrook, ME 04092-4715
Mailing address
300 Main St
Westbrook, ME 04092-4715
Phone (207) 807-1692
Other providers in Westbrook, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 27, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.