| Bangor Psychiatric Associates, Pa | |
|
444 Stillwater Ave Ste 210 Bangor ME 04401-3500 | |
| (207) 907-4311 | |
| (207) 907-4322 |
| Full Name | Bangor Psychiatric Associates, Pa |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 444 Stillwater Ave Ste 210, Bangor, Maine |
| Authorized Official Name and Position | Michelle Henneberry (PRESIDENT) |
| Authorized Official Contact | 2079076311 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bangor Psychiatric Associates, Pa 444 Stillwater Ave Ste 210 Bangor ME 04401-3500 Ph: (207) 907-4311 | Bangor Psychiatric Associates, Pa 444 Stillwater Ave Ste 210 Bangor ME 04401-3500 Ph: (207) 907-4311 |
| NPI Number | 1740356997 |
|---|---|
| Provider Enumeration Date | 11/28/2006 |
| Last Update Date | 12/08/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740356997 | NPI | - | NPPES |
| 105740000 | Medicaid | ME | |
| 048918 | Other | ME | ANTHEM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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