Individual
KATARINA PROKOPOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
242 BRUNSWICK ST, OLD TOWN, ME 04468-1613
(207) 827-6128
(207) 827-6605
Mailing address
PO BOX 1599, BANGOR, ME 04402-1599
(207) 945-5247
(207) 947-0435
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD16221
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
305150099
—
ME
Enumeration date
06/28/2006
Last updated
05/05/2021
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