Individual
GEORGIA BALLEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
149 MAIN ST, WATERVILLE, ME 04901-6623
(207) 453-0322
(207) 453-3093
Mailing address
10 WATER ST STE 202, WATERVILLE, ME 04901-6565
(207) 873-9841
(207) 873-9845
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
EC171046
ME
Other
Enumeration date
07/13/2017
Last updated
07/13/2017
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