Individual
MARK W FOURRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-7046
(207) 662-7054
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-7046
(207) 662-7054
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD12773
ME
Other
Enumeration date
10/18/2005
Last updated
09/19/2012
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