Individual
IVAN KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
360 BROADWAY, BANGOR, ME 04401-3979
(207) 262-1703
(207) 262-1106
Mailing address
360 BROADWAY, BANGOR, ME 04401-3979
(207) 262-1703
(207) 262-1106
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
7475
ME
Other
Enumeration date
11/13/2006
Last updated
07/08/2007
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