Provider Demographics
NPI:1669556494
Name:CUTHBERTSON, DAVID ALAN (AUD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALAN
Last Name:CUTHBERTSON
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 SHORT STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605-1718
Mailing Address - Country:US
Mailing Address - Phone:207-667-4014
Mailing Address - Fax:844-506-7400
Practice Address - Street 1:11 SHORT STREET
Practice Address - Street 2:SUITE B
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-1718
Practice Address - Country:US
Practice Address - Phone:207-667-4014
Practice Address - Fax:844-506-7400
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP684231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MECU040864Medicare PIN