Healthcare Provider Details

I. General information

NPI: 1043802622
Provider Name (Legal Business Name): ERIK INBAR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2021
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 BANGOR MALL BLVD # 1029
BANGOR ME
04401-3632
US

IV. Provider business mailing address

180 BANGOR MALL BLVD # 1029
BANGOR ME
04401-3632
US

V. Phone/Fax

Practice location:
  • Phone: 207-450-3793
  • Fax: 207-221-1503
Mailing address:
  • Phone: 207-450-3793
  • Fax: 207-221-1503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC22719
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: