Organization
FORE RIVER UROLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEGAN SHOREY (PRACTICE MANAGER)
(207) 518-6617
Entity
Organization
Contact information
Practice address
21 DONALD B DEAN DR, SUITE 1, SOUTH PORTLAND, ME 04106-3252
(207) 518-6617
(207) 541-7445
Mailing address
21 DONALD B DEAN DR, SUITE 1, SOUTH PORTLAND, ME 04106-3252
(207) 518-6617
(207) 541-7445
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
ME
Other
Enumeration date
10/28/2014
Last updated
10/28/2014
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