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General NPI Number Information
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NPI Number | 1831294107
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Entity Type | Individual
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Provider Name | JOSEPH ANTHONY SARDINA MD
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Gender | Male
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 08/28/2019
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Provider Practice Location Address
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Address Line | 915 UNION ST
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City | BANGOR
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State | ME
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Zip | 04401-8602
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Country | US
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Telephone | 207-973-8030
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Fax | 207-973-6005
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Provider Business Mailing Address
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Address Line | 43 WHITING HILL RD STE 300
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City | BREWER
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State | ME
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Zip | 04412-1006
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Country | US
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Telephone | 207-973-7000
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 013598
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License Number State | ME
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