Provider Demographics
NPI:1093292807
Name:NADEAU, ROBERT G (DC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:G
Last Name:NADEAU
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-6300
Mailing Address - Country:US
Mailing Address - Phone:207-777-1104
Mailing Address - Fax:207-777-7354
Practice Address - Street 1:336 CENTER ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-6300
Practice Address - Country:US
Practice Address - Phone:207-777-1104
Practice Address - Fax:207-777-7354
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty