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General NPI Number Information
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NPI Number | 1154399905
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Entity Type | Individual
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Provider Name | MARY C. VAUGHAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/09/2006
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Last Update Date | 10/29/2013
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Provider Practice Location Address
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Address Line | 16 HOSPITAL DR STE C.
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City | YORK
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State | ME
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Zip | 03909-1011
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Country | US
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Telephone | 207-351-3455
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Fax | 207-351-3454
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Provider Business Mailing Address
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Address Line | 15 HOSPITAL DR
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City | YORK
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State | ME
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Zip | 03909-1011
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Country | US
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Telephone | 207-351-3455
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Fax | 207-351-3461
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 0101050803
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD17375
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License Number State | ME
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