Provider Demographics
NPI:1366460537
Name:NOBEL, PATRICIA ALYCE (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ALYCE
Last Name:NOBEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 ENFIELD RD
Mailing Address - Street 2:P.O. BOX 579
Mailing Address - City:LINCOLN
Mailing Address - State:ME
Mailing Address - Zip Code:04457
Mailing Address - Country:US
Mailing Address - Phone:207-794-3299
Mailing Address - Fax:207-794-3305
Practice Address - Street 1:26 ENFIELD RD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:ME
Practice Address - Zip Code:04457
Practice Address - Country:US
Practice Address - Phone:207-794-3299
Practice Address - Fax:207-794-3305
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME013440208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MM4480Medicare ID - Type Unspecified
D35864Medicare UPIN