Individual
DYLAN WINGFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 478-6024
Mailing address
324 GANNETT DR STE 200, SOUTH PORTLAND, ME 04106-3266
(207) 482-7800
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD24848
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043743214
—
ME
Enumeration date
04/05/2017
Last updated
06/01/2021
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