Individual
DR. DANIEL MAZZA III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
ONE MEDICAL CENTER DRIVE, BIDDEFORD, ME 04005
(207) 294-5050
Mailing address
ONE MEDICAL CENTER DRIVE, BIDDEFORD, ME 04005
(207) 283-7000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
10162
NH
207Q00000X
Family Medicine Physician
Primary
1112
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124102389
—
ME
05
—
30010895
—
NH
Enumeration date
10/24/2006
Last updated
10/25/2012
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