Individual
LISA T MARRACHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
109 SILVER ST, WATERVILLE, ME 04901
(207) 872-0866
(207) 872-8098
Mailing address
109 SILVER ST, WATERVILLE, ME 04901
(207) 872-0866
(207) 872-8098
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
015761
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027974
ANTHEM
ME
05
—
132890099
—
ME
Enumeration date
08/31/2006
Last updated
03/17/2008
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