Healthcare Provider Details

I. General information

NPI: 1548365828
Provider Name (Legal Business Name): THOMAS F. LEVER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 02/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1068 UNION ST
BANGOR ME
04401
US

IV. Provider business mailing address

PO BOX 1599
BANGOR ME
04402-1599
US

V. Phone/Fax

Practice location:
  • Phone: 207-947-0147
  • Fax: 207-990-3365
Mailing address:
  • Phone: 207-945-5247
  • Fax: 207-947-0435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number011479
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: