Individual
KENDRA MARIE PARADIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
900 BROADWAY BLDG 3, BANGOR, ME 04401-1900
(207) 907-3777
(207) 907-3778
Mailing address
C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT, PO BOX 7291, LEWISTON, ME 04243-7291
(207) 777-8941
(207) 777-4397
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO2873
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588012314
—
ME
Enumeration date
06/02/2016
Last updated
10/24/2023
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