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Organization

VILLI P ENDERS PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VILLI ENDERS MD (OWNER)
(207) 828-2020
Entity
Organization

Contact information

Practice address
53 SEWALL ST, PORTLAND, ME 04102-2625
(207) 828-2020
Mailing address
PO BOX 810, WESTBROOK, ME 04098-0810
(207) 854-1544

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
012829
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1740263433
INDIVIDUAL NPI #
ME
Enumeration date
03/26/2009
Last updated
03/30/2009
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