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Organization
RETINA CENTER OF MAINE, LLC PA
Active
Organization
RETINA CENTER OF MAINE, LLC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK WILSON BALLES MD (MD / PRACTICE OWNER)
(207) 773-3937
Entity
Organization
Contact information
Practice address
195 FORE RIVER PKWY STE 480, PORTLAND, ME 04102-2787
(207) 773-3937
(207) 773-0801
Mailing address
195 FORE RIVER PKWY STE 480, PORTLAND, ME 04102-2787
(207) 773-3937
(207) 773-0801
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
MD14047
ME
Other
Enumeration date
11/15/2007
Last updated
04/18/2017
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