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NPI Code Detail

MEDICARE: DR. HAROLD WILLIAMS VAN LONKHUYZEN MD

MEDICARE: DR. HAROLD WILLIAMS VAN LONKHUYZEN 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
12084P0800XPsychiatry Physician015641ME

General Provider Information

NPI Number : 1568576403
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HAROLD WILLIAMS VAN LONKHUYZEN MD
Provider Business Mailing Address
First Line : 78 ATLANTIC PLACE
Second Line :
City : SOUTH PORTLAND
State : ME
Zip : 04106-2316
Country : US
Telephone Number : 207-842-6556
Fax Number : 207-842-7773
Provider Business Practice Location Address
First Line : 12 UNION STREET
Second Line :
City : ROCKLAND
State : ME
Zip : 04841-2739
Country : US
Telephone Number : 207-701-4402
Fax Number : 207-701-4486
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2006
Last Update Date : 11/04/2010

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