Individual
JENNIFER DIEHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
211 MAIN ST, WATERVILLE, ME 04901-6117
(207) 877-3400
(207) 877-3401
Mailing address
15 ENTERPRISE DR, AUGUSTA, ME 04330-7894
(207) 621-8800
(207) 621-8801
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
017871
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003944646
—
ME
Enumeration date
03/02/2007
Last updated
03/03/2020
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