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General NPI Number Information
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NPI Number | 1891943197
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Entity Type | Organization
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Legal Business Name | DAVID MARGOLIS PH.D. P.A.
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Dates
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Enumeration Date | 08/29/2008
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Last Update Date | 04/11/2016
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Provider Practice Location Address
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Address Line | 68 BISHOP ST UNIT #1
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City | PORTLAND
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State | ME
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Zip | 04103-2681
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Country | US
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Telephone | 207-780-0014
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Fax |
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Provider Business Mailing Address
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Address Line | 68 BISHOP ST UNIT #1
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City | PORTLAND
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State | ME
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Zip | 04103-2681
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Country | US
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Telephone | 207-780-0014
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. DAVID MARGOLIS
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Credential | PH.D.
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Telephone | 207-780-0014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 406
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License Number State | ME
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