Individual
JOHN F VANADIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
360 BROADWAY, BANGOR, ME 04401-3979
(207) 907-3650
(207) 907-3660
Mailing address
C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT, PO BOX 7291, LEWISTON, ME 04243-7291
(207) 777-8560
(207) 777-8800
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
1149
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040754
ANTHEM BS ID
ME
05
—
234340099
—
ME
01
—
2677016
CIGNA ID
ME
Enumeration date
12/18/2006
Last updated
02/03/2022
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