Individual
MICHAEL HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-0111
Mailing address
324 GANNETT DR STE 200, SOUTH PORTLAND, ME 04106-3266
(207) 482-7800
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
A168636
CA
207L00000X
Anesthesiology Physician
Primary
MD26140
ME
207LP3000X
Pediatric Anesthesiology Physician
A168636
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649625500
—
ME
Enumeration date
04/28/2016
Last updated
08/10/2022
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