Individual
DR. LUKE W BALLENGER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 CAMPUS AVE, SUITE 208, LEWISTON, ME 04240-6040
(207) 777-8974
(207) 777-8946
Mailing address
PO BOX 4140, BOSTON, MA 02241
(207) 777-4111
(207) 783-6660
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
014003
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
328040099
—
ME
Enumeration date
07/01/2006
Last updated
02/16/2010
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