Individual
TIN HA NGOC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
575 MAIN ST, GORHAM, ME 04038-2623
(207) 839-2559
(207) 523-1135
Mailing address
PO BOX 9746, PORTLAND, ME 04104-5040
(207) 791-3888
(207) 828-7850
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD20742
ME
Other
Enumeration date
06/27/2012
Last updated
09/23/2020
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