Individual
LARS M ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3 GLEN COVE DR STE 3, ROCKPORT, ME 04856-4232
(207) 301-5400
(207) 301-5301
Mailing address
3 GLEN COVE DR STE 3, ROCKPORT, ME 04856-4232
(207) 301-5400
(207) 301-5301
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
A83598
CA
208800000X
Urology Physician
Primary
MD17463
ME
Other
Enumeration date
12/06/2005
Last updated
05/20/2025
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