Individual
ANNE LONGTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
65 WATERVILLE ST, PORTLAND, ME 04101
(314) 255-9796
Mailing address
300 MAIN ST, LEWISTON, ME 04240-7027
(207) 795-0111
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD22067
ME
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/22/2015
Last updated
08/27/2018
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