Individual
DR. ALI KHAVARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 BROADWAY, SUITE 2, BANGOR, ME 04401-5201
(207) 973-8881
(207) 947-5368
Mailing address
43 WHITING HILL RD, BREWER, ME 04412-1005
(207) 973-8881
(207) 973-8880
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
009535
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110720099
—
ME
Enumeration date
06/21/2005
Last updated
02/28/2014
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