MEDICARE: DR. ROSLYN GERWIN 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
1	2084P0800X	Psychiatry Physician	248075	MA
2	2084P0800X	Psychiatry Physician	DO2494	ME

General Provider Information

NPI Number	:	1710274709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROSLYN GERWIN D.O.

Provider Business Mailing Address
First Line	:	66 BRAMHALL ST
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04102-3344
Country	:	US
Telephone Number	:	207-662-2221
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 SOUTHBOROUGH DR
Second Line	:	SUITE 201
City	:	SOUTH PORTLAND
State	:	ME
Zip	:	04106-6914
Country	:	US
Telephone Number	:	207-661-2000
Fax Number	:

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

Provider Enumeration Date	:	06/29/2011
Last Update Date	:	08/18/2016

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