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Individual

DR. FRED D RISSER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
42 CEDAR ST, BANGOR, ME 04401-6433
(207) 947-0366
Mailing address
44 SILVER RDG, VEAZIE, ME 04401-7084
(207) 947-0366

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
014652
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
234980099
ME
01
260047956
RAILROAD MEDICARE
ME
Enumeration date
03/12/2007
Last updated
11/03/2009
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