Individual
DR. GEORGE W STOCKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
409 ROOSEVELT TRL, WINDHAM, ME 04062-4821
(207) 893-0290
(207) 400-8633
Mailing address
144 STATE ST, PORTLAND, ME 04101-3776
(207) 879-3000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1354
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133040000
—
ME
Enumeration date
07/09/2006
Last updated
02/17/2012
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