Individual
CARMEN DENISE CROFOOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
925 UNION ST STE 3, BANGOR, ME 04401-3051
(207) 973-9980
(207) 973-9980
Mailing address
43 WHITING HILL ROAD, SUITE 300, BREWER, ME 04412
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
017380
ME
207X00000X
Orthopaedic Surgery Physician
6049436-1205
UT
207X00000X
Orthopaedic Surgery Physician
MD423432
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102839688
—
ME
Enumeration date
05/17/2006
Last updated
11/22/2017
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