Provider Demographics
NPI:1386603215
Name:MINOT, PAUL L (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:L
Last Name:MINOT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CHASE AVE
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-4624
Mailing Address - Country:US
Mailing Address - Phone:207-861-5232
Mailing Address - Fax:207-861-5233
Practice Address - Street 1:30 CHASE AVE
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-4624
Practice Address - Country:US
Practice Address - Phone:207-861-5232
Practice Address - Fax:207-861-5233
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME0158052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEC19441Medicare UPIN
MERX0575Medicare PIN
MEMM9031Medicare PIN
ME260048182Medicare PIN