Individual
STEPHEN R GOLDBAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
195 FORE RIVER PKWY STE 407, PORTLAND, ME 04102-2780
(207) 749-6612
(207) 747-4077
Mailing address
195 FORE RIVER PKWY STE 470, PORTLAND, ME 04102-2787
(207) 373-0770
(207) 808-8500
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
1678
ME
207Q00000X
Family Medicine Physician
1678
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003892605
—
ME
Enumeration date
12/16/2005
Last updated
03/14/2022
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