Kenneth Maisak DPM

NPI 1710125596 - Podiatrist - 213ES0103X

NPI Details
NPI 1710125596
Gender Male
Enumeration Date 02/02/2009
Last Updated 09/05/2012
Entity Type Individual
Active Over 7 years ago
Practice Location
68 MARGINAL WAY
PORTLAND ME, 04101-2444, US
Phone (207) 879-1339
Fax (207) 879-1092
Business Location
68 MARGINAL WAY
PORTLAND ME, 04101-2444, US
Phone (207) 879-1339
Fax (207) 879-1092
Toxanomy
Taxonomy Code 213ES0103X
License State Maine
License Number POD1077
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According to our database, Kenneth Maisak DPM NPI is 1710125596, taxonomy code is 213ES0103X and license number is POD1077, license state is located at Maine. Kenneth Maisak DPM physically located at 68 Marginal Way, Portland ME, 04101-2444. NPI Number Kenneth Maisak DPM has the Individual type.

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1710125596 NPI number is provided on an as is basis without warranty of any kind. 1710125596 is maintained by the National Plan & Provider Enumeration System. The contents of Kenneth Maisak DPM are for informational purposes only.