| NPI | 1366474611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN MCCORMACK Chief Operating Officer 207-791-3801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 207QS0010X Family Medicine, Sports Medicine | |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 364SA2200X Clinical Nurse Specialist, Adult Health | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2024-09-25 |