Individual
MARY L CALLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10 GOODALL DRIVE, SANFORD, ME 04073-2621
(207) 490-7790
Mailing address
1 MEDICAL CENTER DR, BIDDEFORD, ME 04005-9422
(207) 283-7000
(207) 282-9128
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD18602
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
435883199
—
ME
Enumeration date
12/28/2006
Last updated
04/16/2014
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