Individual
DR. RICHARD E. NILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12 UNION ST, ROCKLAND, ME 04841-2739
(207) 701-4400
(207) 701-4487
Mailing address
78 ATLANTIC PL, SOUTH PORTLAND, ME 04106-2316
(207) 661-6654
(207) 842-7773
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD18594
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010021117CT01
ANTHEM BLUE CROSS BLUE SH
CT
Enumeration date
07/15/2006
Last updated
07/15/2016
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