Basic Information
| Provider Information | |||||||||
| NPI: | 1588669782 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DUBOIS | ||||||||
| FirstName: | DONALD | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 468 | ||||||||
| Address2: | |||||||||
| City: | SKOWHEGAN | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049760468 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2078588353 | ||||||||
| FaxNumber: | 2074749261 | ||||||||
| Practice Location | |||||||||
| Address1: | 62 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | SKOWHEGAN | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049761146 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2078584844 | ||||||||
| FaxNumber: | 2078580348 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2005 | ||||||||
| LastUpdateDate: | 08/31/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/31/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 013036 | ME | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 013036 | ME | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 010538586 | 01 | ME | HARVARD PILGRIM | OTHER | 252370099 | 05 | ME | MEDICAID | 2386238 | 01 | ME | AETNA | OTHER | 027630 | 01 | ME | ANTHEM BCBS | OTHER | 010538586 | 01 | ME | MEDNET | OTHER | M61971C | 01 | ME | CIGNA | OTHER |