Healthcare Provider Details

I. General information

NPI: 1063486744
Provider Name (Legal Business Name): MARIO TURI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 09/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

364 PRITHAM AVE
GREENVILLE ME
04441-1129
US

IV. Provider business mailing address

364 PRITHAM AVE
GREENVILLE ME
04441-1129
US

V. Phone/Fax

Practice location:
  • Phone: 207-695-5220
  • Fax: 207-695-2329
Mailing address:
  • Phone: 207-695-5220
  • Fax: 207-695-2329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number013070
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: