Organization
NORTHERN RADIOLOGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURENCE A WATTERSON M.D. (PRESIDENT)
(207) 762-4641
Entity
Organization
Contact information
Practice address
49 2ND ST, PRESQUE ISLE, ME 04769-2637
(207) 762-4641
(207) 762-3336
Mailing address
49 2ND ST, PRESQUE ISLE, ME 04769-2637
(207) 762-4641
(207) 762-3336
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N1000
ANTHEM BC/BS
ME
Enumeration date
07/08/2006
Last updated
08/22/2020
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