Provider Demographics
NPI:1689649204
Name:HOWARD, ROBERT T III (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:T
Last Name:HOWARD
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 MILES CENTER WAY
Mailing Address - Street 2:
Mailing Address - City:DAMARISCOTTA
Mailing Address - State:ME
Mailing Address - Zip Code:04543-4047
Mailing Address - Country:US
Mailing Address - Phone:207-563-4700
Mailing Address - Fax:207-563-4019
Practice Address - Street 1:24 MILES CENTER WAY
Practice Address - Street 2:
Practice Address - City:DAMARISCOTTA
Practice Address - State:ME
Practice Address - Zip Code:04543-4047
Practice Address - Country:US
Practice Address - Phone:207-563-4700
Practice Address - Fax:207-563-4019
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD17463207V00000X
IDMC-0896207V00000X
ME018379207V00000X
MA153797207V00000X
MEMD18379207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1689649204Medicaid
ME001275205Medicare PIN
ME1689649204Medicaid