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Individual

MARK EUGENE BOLDUC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
325 KENNEDY MEMORIAL DR # B, WATERVILLE, ME 04901-4517
(207) 872-7171
(207) 877-7268
Mailing address
325 KENNEDY MEMORIAL DR # B, WATERVILLE, ME 04901-4517
(207) 872-7171
(207) 877-7268

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
011486
ME
2086S0129X
Vascular Surgery Physician
Primary
011486
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
039918
ANTHEM BLUE CROSS
ME
01
M101030
CIGNA
ME
Enumeration date
07/31/2006
Last updated
02/21/2014
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