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Physicians Psychiatry & Neurology Psychiatry

Provider NPI: 1336353747

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
Tel: 207-667-0909  Fax: 207-667-6348

Business Mailing Address:
PO BOX 787  ELLSWORTH, ME 04605-0787 US
Tel: 207-667-0909  Fax: 207-667-6348

NPI Information:
NPI: 1336353747
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Psychiatry & Neurology

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 2084P0800X





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