Provider Demographics
NPI:1205924347
Name:OGUIN, GWENDOLYN (DO)
Entity type:Individual
Prefix:
First Name:GWENDOLYN
Middle Name:
Last Name:OGUIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:10 FOREST FALLS DR
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-6936
Mailing Address - Country:US
Mailing Address - Phone:207-846-8722
Mailing Address - Fax:207-846-8723
Practice Address - Street 1:20 MUSSEY RD
Practice Address - Street 2:SUITE 2
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-9570
Practice Address - Country:US
Practice Address - Phone:207-885-1333
Practice Address - Fax:207-885-1337
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2013-05-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ME1134207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEE45081Medicare UPIN
MEMM0276Medicare PIN