Provider Demographics
NPI:1073500807
Name:NUTTING, ROBERT W (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:W
Last Name:NUTTING
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:ROBERT
Other - Middle Name:W
Other - Last Name:NUTTING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:430 TOWN FARM RD
Mailing Address - Street 2:P.O.BOX 100
Mailing Address - City:OAKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04963-4209
Mailing Address - Country:US
Mailing Address - Phone:207-465-7139
Mailing Address - Fax:
Practice Address - Street 1:430 TOWN FARM RD
Practice Address - Street 2:BOX 100
Practice Address - City:OAKLAND
Practice Address - State:ME
Practice Address - Zip Code:04963-4209
Practice Address - Country:US
Practice Address - Phone:207-465-7139
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR2892183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist