Individual
JON PATRICK DONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
71 US ROUTE 1, SUITE C, SCARBOROUGH, ME 04074-7173
(207) 883-5532
Mailing address
5 PEARL STREET, CAPE ELIZABETH, ME 04107
(207) 799-6096
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
MD14324
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
315420099
—
ME
Enumeration date
10/02/2006
Last updated
01/03/2020
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