Provider Demographics
NPI:1013986033
Name:WESTCOT, ROBERT OCTAVE II (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:OCTAVE
Last Name:WESTCOT
Suffix:II
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 1:22 WEST COLE ROAD
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-9430
Mailing Address - Country:US
Mailing Address - Phone:207-284-5880
Mailing Address - Fax:207-283-1543
Practice Address - Street 1:22 WEST COLE ROAD
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-9430
Practice Address - Country:US
Practice Address - Phone:207-284-5880
Practice Address - Fax:207-283-1543
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME012847207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME126680000Medicaid
MM2746Medicare ID - Type Unspecified