Healthcare Provider Details

I. General information

NPI: 1356313902
Provider Name (Legal Business Name): PHILIP H MCFARLANE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 05/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 HARTFORD ST
HOULTON ME
04730-1844
US

IV. Provider business mailing address

22 HARTFORD ST
HOULTON ME
04730-1844
US

V. Phone/Fax

Practice location:
  • Phone: 207-532-3289
  • Fax: 207-532-6071
Mailing address:
  • Phone: 207-532-3289
  • Fax: 207-532-6071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD7263
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: