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General NPI Number Information
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NPI Number | 1205060225
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Entity Type | Individual
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Provider Name | ANN K MAGNER DO
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Gender | Female
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Dates
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Enumeration Date | 05/05/2009
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Last Update Date | 10/04/2013
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Provider Practice Location Address
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Address Line | 66 BRAMHALL ST
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City | PORTLAND
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State | ME
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Zip | 04102
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Country | US
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Telephone | 207-662-3157
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Fax | 207-662-4257
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Provider Business Mailing Address
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Address Line | 301C US RT 1
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City | SCARBOROUGH
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State | ME
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Zip | 04074
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Country | US
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Telephone | 207-396-8600
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Fax | 207-396-8632
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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 | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | D02298
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO2298
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License Number State | ME
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