Basic Information
| Provider Information | |||||||||
| NPI: | 1336671056 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DICOLA | ||||||||
| FirstName: | DOUGLAS | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | MAINEGENERAL MEDICAL CENTER | ||||||||
| Address2: | 149 NORTH ST | ||||||||
| City: | WATERVILLE | ||||||||
| State: | ME | ||||||||
| PostalCode: | 04901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2078615000 | ||||||||
| FaxNumber: | 2078615001 | ||||||||
| Practice Location | |||||||||
| Address1: | MAINEGENERAL MEDICAL CENTER | ||||||||
| Address2: | 149 NORTH ST | ||||||||
| City: | WATERVILLE | ||||||||
| State: | ME | ||||||||
| PostalCode: | 04901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2078615000 | ||||||||
| FaxNumber: | 2078615001 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2017 | ||||||||
| LastUpdateDate: | 08/06/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD23711 | ME | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.