Provider Demographics
NPI:1891898466
Name:OUIMET, PHILIPPE (LAC)
Entity Type:Individual
Prefix:
First Name:PHILIPPE
Middle Name:
Last Name:OUIMET
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 AUGUSTA RD
Mailing Address - Street 2:STE 2
Mailing Address - City:WINSLOW
Mailing Address - State:ME
Mailing Address - Zip Code:04901
Mailing Address - Country:US
Mailing Address - Phone:207-872-0688
Mailing Address - Fax:207-872-0688
Practice Address - Street 1:342 AUGUSTA RD
Practice Address - Street 2:STE 2
Practice Address - City:WINSLOW
Practice Address - State:ME
Practice Address - Zip Code:04901
Practice Address - Country:US
Practice Address - Phone:207-872-0688
Practice Address - Fax:207-872-0688
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAC14171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME043308OtherANTHEM