Individual
RANDALL L SISAM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
180 KENNEDY MEMORIAL DR, WATERVILLE, ME 04901-4540
(207) 872-5529
(207) 872-9219
Mailing address
180 KENNEDY MEMORIAL DR, WATERVILLE, ME 04901-4541
(207) 872-5529
(207) 872-9219
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
LT06104A
ME
Other
Enumeration date
05/11/2006
Last updated
07/08/2007
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