JUSTIN OTIS

BANGOR, ME
NPI1962817619
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry
(Licence: ME  MD26700)
Additional Taxonomies2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry
(Licence: IA  MD-48057)
2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry
(Licence: CO  CDRH.0060526)
2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry
(Licence: WI  404-320)
2084N0400X Psychiatry & Neurology, Neurology
(Licence: WI  404)
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: WI  404-320)
Enumeration Date2014-06-20
Last Update Date2023-02-24
Business Address
JUSTIN OTIS MD
268 STILLWATER AVE
BANGOR, ME 04401-3945
Phone number: 207-973-6100
Mailing Address
JUSTIN OTIS MD
268 STILLWATER AVE
BANGOR, ME 04401-3945
Phone number: 207-973-6100