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Individual

ALLAN M INGRAHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
60 HIGH ST, CMHVI-Y1, LEWISTON, ME 04240
(207) 795-8260
(207) 795-8281
Mailing address
124 SHEPLEY ST, AUBURN, ME 04210
(207) 784-4722

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
9007
ME
2086S0129X
Vascular Surgery Physician
Primary
9007
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110030000
ME
Enumeration date
01/09/2006
Last updated
08/02/2012
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