Individual
CAROL M VAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
84 MARGINAL WAY, SUITE 900, PORTLAND, ME 04101-2443
(207) 874-2445
(207) 523-8598
Mailing address
100 FODEN RD WEST, SUITE 203, SOUTH PORTLAND, ME 04106-2327
(207) 828-0361
(207) 874-1483
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
015453
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
037999
ANTHEM
—
01
—
2229081
AETNA
—
05
—
318650099
—
ME
Enumeration date
03/15/2006
Last updated
11/16/2010
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