Individual
DR. RUTH E TALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
417 STATE ST, STE 400, BANGOR, ME 04401
(207) 942-6096
(207) 973-8857
Mailing address
417 STATE ST, STE 400, BANGOR, ME 04401
(207) 942-6096
(207) 973-8857
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
015673
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061678
BLUE CROSS
ME
05
—
4320121799
—
ME
Enumeration date
03/14/2006
Last updated
11/25/2014
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