Individual
DR. ROBERT TRISTIAN ISOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 CONGRESS ST STE B, PORTLAND, ME 04102-2148
(207) 774-5222
Mailing address
1600 CONGRESS ST STE B, PORTLAND, ME 04102-2148
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
217627
NY
207RN0300X
Nephrology Physician
Primary
MD25822
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02423449
—
NY
Enumeration date
11/01/2006
Last updated
05/24/2022
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