Provider Demographics
NPI:1679296800
Name:GATEWOOD, EILEEN S (LAC, DACM, MAOM)
Entity type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:S
Last Name:GATEWOOD
Suffix:
Gender:F
Credentials:LAC, DACM, MAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 SEARSPORT AVE
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-7220
Mailing Address - Country:US
Mailing Address - Phone:207-323-6821
Mailing Address - Fax:
Practice Address - Street 1:90 SEARSPORT AVE
Practice Address - Street 2:
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915-7220
Practice Address - Country:US
Practice Address - Phone:207-323-6821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAC736171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist