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NPI Code Detail

MEDICARE: DR. MARTIN FRANCIS WESOLOWSKI D.O.

MEDICARE: DR. MARTIN FRANCIS WESOLOWSKI D.O.
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
1207Q00000XFamily Medicine Physician2252ME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437487121
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARTIN FRANCIS WESOLOWSKI D.O.
Provider Business Mailing Address
First Line : PO BOX 9746
Second Line :
City : PORTLAND
State : ME
Zip : 04104-5040
Country : US
Telephone Number : 207-791-3888
Fax Number : 207-828-7850
Provider Business Practice Location Address
First Line : 575 MAIN ST
Second Line :
City : GORHAM
State : ME
Zip : 04038-1339
Country : US
Telephone Number : 207-839-2559
Fax Number : 207-523-1135
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2009
Last Update Date : 09/23/2020

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