Provider Demographics
NPI:1982485843
Name:BLYLER, ABIGAIL WHITMAN
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:WHITMAN
Last Name:BLYLER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04092-2820
Mailing Address - Country:US
Mailing Address - Phone:207-854-8443
Mailing Address - Fax:
Practice Address - Street 1:870 MAIN ST
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-2820
Practice Address - Country:US
Practice Address - Phone:207-854-8443
Practice Address - Fax:207-854-9235
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-06
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR71753333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy