MEDICARE: ANNE HALLWARD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	015706	ME

General Provider Information

NPI Number	:	1417034711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE HALLWARD MD

Provider Business Mailing Address
First Line	:	22 FREE ST
Second Line	:	SUITE 402
City	:	PORTLAND
State	:	ME
Zip	:	04101-3960
Country	:	US
Telephone Number	:	207-651-6412
Fax Number	:	207-651-6412

Provider Business Practice Location Address
First Line	:	22 FREE ST
Second Line	:	SUITE 402
City	:	PORTLAND
State	:	ME
Zip	:	04101-3960
Country	:	US
Telephone Number	:	207-651-6412
Fax Number	:	207-773-0709

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	08/14/2012

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