Individual
DR. KRYSTIAN W BIGOSINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 BRICKHILL AVENUE, SUITE 303, SOUTH PORTLAND, ME 04106
(207) 773-0040
(207) 824-4900
Mailing address
301C US ROUTE ONE, SCARBOROUGH, ME 04074
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
036121017
IL
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
MD20416
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036121017
IL STATE MEDICAL LICENSE
IL
01
—
ML20008426
STATE MEDICAL LISCENCE
WA
Enumeration date
04/26/2007
Last updated
12/29/2014
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