Healthcare Provider Details

I. General information

NPI: 1295722577
Provider Name (Legal Business Name): WESTERN MAINE RADIOLOGY, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 MAIN ST
NORWAY ME
04268-5664
US

IV. Provider business mailing address

PO BOX 986520 DEPARTMENT 280
BOSTON MA
02298-6520
US

V. Phone/Fax

Practice location:
  • Phone: 207-743-5933
  • Fax:
Mailing address:
  • Phone: 207-784-2554
  • Fax: 207-777-1439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT BARIL
Title or Position: PRESIDENT
Credential: DO
Phone: 207-743-5933