| Maine Functional Medicine | |
|
33 Penn Plz Ste A Bangor ME 04401-3619 | |
| (207) 941-0080 | |
| (207) 941-0093 |
| Full Name | Maine Functional Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 33 Penn Plz Ste A, Bangor, Maine |
| Authorized Official Name and Position | Kelly Drake (OFFICE MANAGER) |
| Authorized Official Contact | 2079410080 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maine Functional Medicine 33 Penn Plz Ste A Bangor ME 04401-3619 Ph: (207) 941-0080 | Maine Functional Medicine 33 Penn Plz Ste A Bangor ME 04401-3619 Ph: (207) 941-0080 |
| NPI Number | 1427512904 |
|---|---|
| Provider Enumeration Date | 01/29/2019 |
| Last Update Date | 01/29/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427512904 | NPI | - | NPPES |
| 1053336206 | Other | ME | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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