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Individual

DR. GORDON ADAIR HEATH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
96 OCEAN ST, UNIT 4, SOUTH PORTLAND, ME 04106-2855
(207) 221-3459
Mailing address
96 OCEAN ST, UNIT 4, SOUTH PORTLAND, ME 04106-2855
(207) 221-3459

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
006396
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
006396
MAINE BOARD OF MEDICINE
ME
01
ME 99738
FLORIDA BOARD OF MEDICINE
FL
Enumeration date
03/04/2008
Last updated
03/04/2008
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