Individual
DR. STEPHEN M WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
78 RIDGEWOOD DR, BANGOR, ME 04401-2652
(207) 307-8901
(207) 307-8911
Mailing address
78 RIDGEWOOD DR, BANGOR, ME 04401-2652
(207) 947-8381
(207) 947-1897
Taxonomy
Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
036115376
IL
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
17389
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432654299
—
ME
01
—
P00460654
RR MEDICARE
—
Enumeration date
05/26/2006
Last updated
07/16/2021
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