Healthcare Provider Details

I. General information

NPI: 1023165081
Provider Name (Legal Business Name): MAURICE PARE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 09/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

656 STATE ST
BANGOR ME
04401-5609
US

IV. Provider business mailing address

656 STATE ST
BANGOR ME
04401-5609
US

V. Phone/Fax

Practice location:
  • Phone: 207-941-4036
  • Fax: 207-941-4062
Mailing address:
  • Phone: 207-941-4036
  • Fax: 207-941-4062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number1117
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number1117
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: