Healthcare Provider Details

I. General information

NPI: 1427043207
Provider Name (Legal Business Name): WILLIAM BENJAMIN ZOLPER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2005
Last Update Date: 05/25/2023
Certification Date: 05/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1365 BROADWAY
BANGOR ME
04401-2401
US

IV. Provider business mailing address

1365 BROADWAY
BANGOR ME
04401-2401
US

V. Phone/Fax

Practice location:
  • Phone: 207-942-6226
  • Fax: 207-992-2756
Mailing address:
  • Phone: 207-942-6226
  • Fax: 207-992-2756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number013538
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number013538
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: