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General NPI Number Information
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NPI Number | 1306951231
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Entity Type | Organization
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Legal Business Name | NORTHERN MAINE AMBULATORY ENDOSCOPY CENTER
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 11 MARTIN ST
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City | PRESQUE ISLE
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State | ME
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Zip | 04769-2238
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Country | US
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Telephone | 207-764-0679
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Fax | 207-764-1569
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Provider Business Mailing Address
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Address Line | 11 MARTIN ST
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City | PRESQUE ISLE
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State | ME
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Zip | 04769-2238
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Country | US
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Telephone | 207-764-0679
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Fax | 207-764-1569
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Authorized Official
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Title or Position | PRESIDENT
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Name | WILLIAM SILBER
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Credential |
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Telephone | 207-764-0679
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 36488
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License Number State | ME
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