Individual
MS. CHRISTINE M MUNROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
57 PORTLAND ST, SUITE 2A, SOUTH BERWICK, ME 03908-1203
(207) 384-9212
(207) 384-2008
Mailing address
57 PORTLAND ST, SUITE 2A, SOUTH BERWICK, ME 03908-1203
(207) 384-9212
(207) 384-2008
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2005
ME
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
2005
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000265601
PTAN
ME
01
—
2005
STATE LICENSE NUMBER
ME
05
—
3022634
—
NH
05
—
432756499
—
ME
Enumeration date
07/18/2007
Last updated
07/09/2010
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