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Individual

CYNTHIA AMANDA SELF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
900 HAMMOND ST # A, BANGOR, ME 04401-4378
(207) 947-6743
(207) 945-4397
Mailing address
900 HAMMOND ST # A, BANGOR, ME 04401-4378
(207) 947-6743
(207) 945-4397

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
016811
ME
207WX0120X
Cornea and External Diseases Specialist Physician
MD16811
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
431809499
ME
Enumeration date
10/11/2005
Last updated
04/05/2018
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