Healthcare Provider Details

I. General information

NPI: 1396750485
Provider Name (Legal Business Name): MARGARET A DUSTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 APPLE TREE LN
MANCHESTER ME
04351-3428
US

IV. Provider business mailing address

17 APPLE TREE LN
MANCHESTER ME
04351-3428
US

V. Phone/Fax

Practice location:
  • Phone: 207-626-0151
  • Fax: 207-623-0359
Mailing address:
  • Phone: 207-626-0151
  • Fax: 207-623-0359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number12278
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: