Individual
JOHN TIVNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1365 BROADWAY, BANGOR, ME 04401-2401
(207) 942-6226
(207) 992-2756
Mailing address
1365 BROADWAY, BANGOR, ME 04401-2401
(207) 942-6226
(207) 992-2756
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
DO3257
ME
208VP0014X
Interventional Pain Medicine Physician
Primary
DO3257
ME
Other
Enumeration date
05/24/2016
Last updated
01/17/2023
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