Individual
CHARLES D CLEMETSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
39 FORESIDE RD, PORTLAND, ME 04110-1405
(207) 415-2700
(207) 899-0138
Mailing address
39 FORESIDE RD, PORTLAND, ME 04110-1405
(207) 415-2700
(207) 899-0138
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
013808
ME
2084P0804X
Child & Adolescent Psychiatry Physician
013808
ME
Other
Enumeration date
02/17/2008
Last updated
06/24/2011
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