Organization
PAUL R. MOULTON, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL RUSH MOULTON M.D. (OWNER)
(207) 945-3619
Entity
Organization
Contact information
Practice address
5 GROVE STREET, BANGOR, ME 04401-5394
(207) 945-3619
(207) 941-0817
Mailing address
5 GROVE STREET, BANGOR, ME 04401-5394
(207) 945-3619
(207) 941-0817
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
012516
ME
Other
Enumeration date
03/17/2008
Last updated
03/17/2008
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