Individual
PAUL RUSH MOULTON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5 GROVE ST, BANGOR, ME 04401-5309
(207) 945-3619
Mailing address
5 GROVE ST, BANGOR, ME 04401-5309
(207) 945-3619
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
012516
ME
Other
Enumeration date
07/20/2005
Last updated
07/09/2007
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