Provider Demographics
NPI:1457867954
Name:PAPSADORA, NATHAN ADAM (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:ADAM
Last Name:PAPSADORA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3340
Mailing Address - Country:US
Mailing Address - Phone:207-262-0190
Mailing Address - Fax:207-262-0196
Practice Address - Street 1:706 BROADWAY
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3340
Practice Address - Country:US
Practice Address - Phone:207-262-0190
Practice Address - Fax:207-262-0196
Is Sole Proprietor?:No
Enumeration Date:2017-12-19
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR46847183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist