Individual
FREDERICK INGLIS RUDOLF EYERER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
417 STATE ST STE 439, BANGOR, ME 04401-6635
(207) 941-8200
(207) 990-4846
Mailing address
53 SPRUCE ST APT 1, PORTLAND, ME 04102-3715
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD26909
ME
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD26909
BOARD OF LICENSURE IN MEDICINE
ME
Enumeration date
03/20/2018
Last updated
06/28/2023
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