Individual
DANIEL JOHN BULANOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 FODEN RD STE 103, SOUTH PORTLAND, ME 04106-2327
(207) 828-1122
Mailing address
100 FODEN RD STE 103, SOUTH PORTLAND, ME 04106-2327
(207) 828-1122
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
263233
MA
207RP1001X
Pulmonary Disease Physician
Primary
MD25789
ME
Other
Enumeration date
06/03/2015
Last updated
07/05/2022
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