Individual
STEPHEN M DONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
582 ROOSEVELT TRAIL, WINDHAM, ME 04062-4904
(207) 892-3233
(207) 893-0752
Mailing address
301 US ROUTE 1, BUILDING C, SCARBOROUGH, ME 04074-7609
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
1581
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
254690099
—
ME
05
—
30226080
—
NH
Enumeration date
10/02/2006
Last updated
06/12/2012
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