Provider Demographics
NPI:1689651069
Name:RICE, ROBERT DE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DE
Last Name:RICE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:272 COTTAGE ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04073-1815
Mailing Address - Country:US
Mailing Address - Phone:207-324-1110
Mailing Address - Fax:207-636-5023
Practice Address - Street 1:272 COTTAGE ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:ME
Practice Address - Zip Code:04073-1815
Practice Address - Country:US
Practice Address - Phone:207-324-1110
Practice Address - Fax:207-636-5023
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME015113207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME134060099Medicaid
MEMM7714Medicare ID - Type Unspecified