Individual
MARY ELIZABETH BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
489 STATE ST, BANGOR, ME 04401-6616
(207) 973-8670
Mailing address
186 NORTHPORT AVE, BELFAST, ME 04915-6073
(207) 338-2010
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
12141
ME
Other
Enumeration date
07/27/2006
Last updated
06/11/2015
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