Provider Demographics
NPI:1831464783
Name:PIERCE, CLIFFORD E
Entity Type:Individual
Prefix:
First Name:CLIFFORD
Middle Name:E
Last Name:PIERCE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 ROOSEVELT TRL
Mailing Address - Street 2:
Mailing Address - City:CASCO
Mailing Address - State:ME
Mailing Address - Zip Code:04015-4211
Mailing Address - Country:US
Mailing Address - Phone:207-655-2000
Mailing Address - Fax:
Practice Address - Street 1:23 ROOSEVELT TRL
Practice Address - Street 2:
Practice Address - City:CASCO
Practice Address - State:ME
Practice Address - Zip Code:04015-4211
Practice Address - Country:US
Practice Address - Phone:207-655-2000
Practice Address - Fax:207-655-2032
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-11
Last Update Date:2012-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1080131332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies