NPI 1427512904

Maine Functional Medicine

Organisation Family Medicine Physician Bangor, ME

Practice location

Address: 33 Penn Plz STE a, Bangor, ME 04401-3619
Phone: (207) 941-0080
Fax: (207) 941-0093

Authorised official

Name: Kelly Drake
Title: Office Manager
Phone: (207) 941-0080

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X

Other Family Medicine providers in Maine →

Registry record

NPI: 1427512904
Entity type: Organization
NPI issued: 29 Jan 2019
Record last updated: 29 Jan 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.