Provider Demographics
NPI:1710105788
Name:MAIERHOFER, ROBERT L (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:MAIERHOFER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 BRUNSWICK AVE
Mailing Address - Street 2:
Mailing Address - City:GARDINER
Mailing Address - State:ME
Mailing Address - Zip Code:04345-2501
Mailing Address - Country:US
Mailing Address - Phone:207-582-3065
Mailing Address - Fax:207-846-9012
Practice Address - Street 1:103 BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:GARDINER
Practice Address - State:ME
Practice Address - Zip Code:04345-2501
Practice Address - Country:US
Practice Address - Phone:207-582-3065
Practice Address - Fax:207-846-9012
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPS514103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME010807OtherPSYCHOLOGIST (ANTHEM)
ME010807OtherPSYCHOLOGIST (ANTHEM)