Individual
DR. BART J. EDMISTON SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
20298
MS
207L00000X
Anesthesiology Physician
EC-05-091
ME
208VP0014X
Interventional Pain Medicine Physician
20298
MS
Other
Enumeration date
11/30/2006
Last updated
12/28/2020
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