Provider Demographics
NPI:1871523134
Name:PECE, CAROLYN R (DO)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:R
Last Name:PECE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1 VA CTR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-6795
Mailing Address - Country:US
Mailing Address - Phone:207-623-8411
Mailing Address - Fax:207-626-4787
Practice Address - Street 1:1 VA CTR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-6795
Practice Address - Country:US
Practice Address - Phone:207-623-8411
Practice Address - Fax:207-626-4787
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME1697207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME293060099Medicaid
MEMM8483Medicare ID - Type Unspecified
ME293060099Medicaid
MEG98899Medicare UPIN