Individual
VIRGINIA A EDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
887 CONGRESS ST., PORTLAND, ME 04102
(207) 774-2311
Mailing address
301 US ROUTE 1, BUILDING C, SCARBOROUGH, ME 04074-7609
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
015532
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30201751
—
NH
05
—
338680099
—
ME
Enumeration date
10/02/2006
Last updated
01/04/2011
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