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Individual

ERIC C LARSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
100 CAMPUS DR, UNIT 107, SCARBOROUGH, ME 04074-9692
(207) 885-7565
(207) 885-7577
Mailing address
190 RIVERSIDE ST, SUITE 6B, PORTLAND, ME 04103-1073
(207) 661-2000
(207) 661-2033

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD16882
ME
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
MD16882
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30003473
NH
05
431781999
ME
Enumeration date
07/02/2006
Last updated
04/26/2017
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