| NPI | 1528280203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN CORBETT Billing Representative 207-497-2996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2008-06-27 |