Individual
MARK W KOLASA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
60 HIGH ST, LEWISTON, ME 04240-7616
(207) 753-3900
(207) 753-3902
Mailing address
60 HIGH ST, LEWISTON, ME 04240-7616
(207) 753-3900
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
MD21491
ME
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
MD21491
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
699153000
—
MN
Enumeration date
08/10/2006
Last updated
11/13/2017
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