Provider Demographics
NPI:1437101870
Name:HAWKINS, TERRANCE DAVID (DO)
Entity Type:Individual
Prefix:
First Name:TERRANCE
Middle Name:DAVID
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 BARNET AVE
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-5102
Mailing Address - Country:US
Mailing Address - Phone:207-873-5044
Mailing Address - Fax:207-873-4344
Practice Address - Street 1:25 FIRST PARK DR
Practice Address - Street 2:SUITE A
Practice Address - City:OAKLAND
Practice Address - State:ME
Practice Address - Zip Code:04963-5361
Practice Address - Country:US
Practice Address - Phone:207-873-4325
Practice Address - Fax:207-873-4344
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1664207R00000X
CA20A 7538207R00000X
CA20A7538208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME331470099Medicaid
MM8447Medicare ID - Type UnspecifiedRAILROAD-INDIVIDUAL ID#
H23367Medicare UPIN