Individual
DR. BRUCE ELLIOTT BLACKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
22 W COLE RD, BIDDEFORD, ME 04005-9430
(207) 283-1118
(207) 286-8792
Mailing address
22 W COLE RD, BIDDEFORD, ME 04005-9430
(207) 283-1118
(207) 286-8792
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
924
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108510000
—
ME
Enumeration date
01/17/2007
Last updated
05/15/2014
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