Individual
BASEM MOHAMED ELBROLOSY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1230 MAINE ST, POLAND, ME 04274-7325
(207) 998-4483
(207) 998-2189
Mailing address
C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT, PO BOX 7291, LEWISTON, ME 04240-7291
(207) 777-8950
(207) 777-8800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD24059
ME
Other
Enumeration date
04/09/2008
Last updated
09/01/2020
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