Individual
DR. JENNIFER M DUBAIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1577 CONGRESS ST, 2ND FLOOR, PORTLAND, ME 04102-2169
(207) 662-1442
(207) 775-2467
Mailing address
300 SOUTHBOROUGH DR, SUITE 201, SOUTH PORTLAND, ME 04106-6914
(207) 661-2000
(207) 661-2033
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
017462
ME
208000000X
Pediatrics Physician
EC-05-090
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432702199
—
ME
Enumeration date
11/30/2006
Last updated
05/13/2016
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