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Individual

RICHARD E FORTIER JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
60 PINELAND DR, NEW GLOUCESTER, ME 04260-5124
(207) 688-8700
(207) 688-8701
Mailing address
60 PINELAND DR, NEW GLOUCESTER, ME 04260-5124
(207) 688-8700
(207) 688-8701

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
8000
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002189
STAR NUMBER
ME
05
203580000
ME
Enumeration date
06/26/2006
Last updated
03/23/2010
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