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Individual

QUAN ZHEN SHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
29 FRANKLIN ST, BANGOR, ME 04401-4909
(207) 942-3816
(207) 561-4725
Mailing address
29 FRANKLIN ST, BANGOR, ME 04401-4909
(207) 942-3816
(207) 561-4725

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS884
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
098303
ANTHEM LEGACY NUMBER
ME
05
214240099
ME
Enumeration date
05/31/2006
Last updated
07/09/2007
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