Individual
O'NEAL VAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
144 STATE ST, PORTLAND, ME 04101
(207) 879-3000
Mailing address
324 GANNETT DR STE 200, SOUTH PORTLAND, ME 04106-3266
(207) 482-7800
(207) 956-6676
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
58. 005960
OH
207L00000X
Anesthesiology Physician
Primary
DO2862
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588617963
—
ME
Enumeration date
05/18/2006
Last updated
07/11/2019
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