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General NPI Number Information
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NPI Number | 1245731082
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Entity Type | Organization
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Legal Business Name | MICHAEL ENG, INTEGRATIVE MEDICINE, PLLC
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Dates
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Enumeration Date | 02/27/2018
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Last Update Date | 02/27/2018
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Provider Practice Location Address
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Address Line | 82 MAIN ST
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City | BRIDGTON
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State | ME
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Zip | 04009-1128
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Country | US
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Telephone | 207-310-3945
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Fax | 207-221-1362
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Provider Business Mailing Address
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Address Line | PO BOX 398
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City | BRIDGTON
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State | ME
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Zip | 04009-0398
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Country | US
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Telephone | 207-310-3945
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Fax | 207-221-1362
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MICHAEL ENG
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Credential | MD
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Telephone | 207-310-3945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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