NPI 1548306723

Primary Care Pediatrics

Organisation Exclusive Provider Organization Bangor, ME

Practice location

Address: 700 Mount Hope Ave STE 640, Bangor, ME 04401-5691
Phone: (207) 947-6739
Fax: (207) 942-3554

Authorised official

Name: Teri Dow
Title: Office Manager
Phone: (207) 947-6739

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 007119 (ME)

Other Exclusive Provider Organization providers in Maine →

Registry record

NPI: 1548306723
Entity type: Organization
NPI issued: 29 Jan 2007
Record last updated: 22 Aug 2020

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.