Organization
MACKLIN & ERVIN MDPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDMUND DOLE ERVIN MD (OWNER)
(207) 873-6183
Entity
Organization
Contact information
Practice address
2 SCHOOL ST, WATERVILLE, ME 04901-7518
(207) 873-6183
(207) 861-5457
Mailing address
2 SCHOOL ST, WATERVILLE, ME 04901-7518
(207) 873-6183
(207) 861-5457
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
010650
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107850099
—
ME
Enumeration date
11/08/2007
Last updated
11/08/2007
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