Benjamin L Park DO

NPI 1205121639 - Student in an Organized Health Care Education/Training Program - 390200000X

NPI Details
NPI 1205121639
Gender Male
Enumeration Date 06/14/2011
Last Updated 11/26/2014
Entity Type Individual
Active Over 5 years ago
Practice Location
22 BRAMHALL ST
PORTLAND ME, 04102-3134, US
Phone (207) 662-7060
Fax (207) 662-7066
Business Location
22 BRAMHALL ST
PORTLAND ME, 04102-3134, US
Phone (207) 662-7060
Fax (207) 662-7066
Toxanomy
Taxonomy Code 390200000X
License State
License Number
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According to our database, Benjamin L Park DO NPI is 1205121639, taxonomy code is 390200000X Benjamin L Park DO physically located at 22 Bramhall St, Portland ME, 04102-3134. NPI Number Benjamin L Park DO has the Individual type.

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1205121639 NPI number is provided on an as is basis without warranty of any kind. 1205121639 is maintained by the National Plan & Provider Enumeration System. The contents of Benjamin L Park DO are for informational purposes only.