Basic Information
| Provider Information | |||||||||
| NPI: | 1154473585 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALAMO | ||||||||
| FirstName: | AQUILINO | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 745 | ||||||||
| Address2: | |||||||||
| City: | NEWCASTLE | ||||||||
| State: | ME | ||||||||
| PostalCode: | 045530745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2075634146 | ||||||||
| FaxNumber: | 2075634103 | ||||||||
| Practice Location | |||||||||
| Address1: | 19 SAINT ANDREWS LN | ||||||||
| Address2: | |||||||||
| City: | BOOTHBAY HARBOR | ||||||||
| State: | ME | ||||||||
| PostalCode: | 045381732 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2076337820 | ||||||||
| FaxNumber: | 2075634103 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2007 | ||||||||
| LastUpdateDate: | 03/16/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 014696 | ME | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 298680099 | 05 | ME | MEDICAID |