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General NPI Number Information
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NPI Number | 1730151697
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Entity Type | Organization
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Legal Business Name | FULL CIRCLE FAMILY MEDICINE
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Dates
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Enumeration Date | 02/06/2006
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Last Update Date | 11/28/2012
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Provider Practice Location Address
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Address Line | 68 CHAPMAN ST
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City | DAMARISCOTTA
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State | ME
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Zip | 04543-4614
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Country | US
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Telephone | 207-563-6623
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Fax | 207-563-6625
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Provider Business Mailing Address
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Address Line | 68 CHAPMAN ST
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City | DAMARISCOTTA
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State | ME
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Zip | 04543-4614
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Country | US
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Telephone | 207-563-6623
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Fax | 207-563-6625
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Authorized Official
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Title or Position | PARTNER/OWNER
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Name | DR. MINDA J GOLD
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Credential | MD
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Telephone | 207-563-6623
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | ME
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