Individual
RENEE FAY-LEBLANC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
180 PARK AVE, PORTLAND, ME 04102-2957
(207) 874-2141
(207) 874-2164
Mailing address
180 PARK AVE, PORTLAND, ME 04102-2957
(207) 874-2141
(207) 874-2164
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
017048
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432190199
—
ME
Enumeration date
06/03/2006
Last updated
12/28/2017
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