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General NPI Number Information
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NPI Number | 1952406308
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Entity Type | Individual
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Provider Name | ROLAND H KNAUSENBERGER 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 | 06/03/2014
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Provider Practice Location Address
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Address Line | 180 KENNEDY MEMORIAL DRIVE STE 202
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City | WATERVILLE
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State | ME
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Zip | 04901
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Country | US
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Telephone | 207-872-2900
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Fax | 207-872-8495
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Provider Business Mailing Address
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Address Line | 174 KENNEDY MEMORIAL DR
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City | WATERVILLE
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State | ME
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Zip | 04901-5134
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Country | US
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Telephone | 800-395-0232
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Fax | 207-861-3281
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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 | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 01428
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License Number State | ME
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