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Individual

CHARLES A PARENT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
24 PORTLAND RD, KENNEBUNK, ME 04043-6747
(207) 604-5085
(207) 604-5083
Mailing address
24 PORTLAND RD, KENNEBUNK, ME 04043-6747
(207) 604-5085
(207) 282-9180

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1565
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
254340099
ME
01
MM716502
MEDICARE PTAN
ME
Enumeration date
07/06/2006
Last updated
09/28/2011
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