Individual
DR. IVAN D CARDONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
195 FORE RIVER PKWY, SUITE 410, PORTLAND, ME 04102
(207) 774-9839
(207) 761-2127
Mailing address
195 FORE RIVER PKWY, SUITE 410, PORTLAND, ME 04102
(207) 774-9839
(207) 761-2127
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
017151
ME
207K00000X
Allergy & Immunology Physician
Primary
017151
ME
2080P0201X
Pediatric Allergy/Immunology Physician
017151
ME
Other
Enumeration date
09/26/2006
Last updated
01/13/2015
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