Provider Demographics
NPI:1053406827
Name:ANDROKITES, ALICE C (MD)
Entity type:Individual
Prefix:MS
First Name:ALICE
Middle Name:C
Last Name:ANDROKITES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4 GLEN COVE DR
Mailing Address - Street 2:PENOBSCOT BAY PHYSICIANS BLDG STE 204
Mailing Address - City:ROCKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04856
Mailing Address - Country:US
Mailing Address - Phone:207-594-4412
Mailing Address - Fax:207-594-4436
Practice Address - Street 1:4 GLEN COVE DR
Practice Address - Street 2:PENOBSCOT BAY PHYSICIANS BLDG STE 204
Practice Address - City:ROCKPORT
Practice Address - State:ME
Practice Address - Zip Code:04856
Practice Address - Country:US
Practice Address - Phone:207-594-4412
Practice Address - Fax:207-594-4436
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME014624207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MM7218Medicare ID - Type Unspecified
B42275Medicare UPIN