Individual
JOHN MAMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6 GLEN COVE DR, ROCKPORT, ME 04856-4272
(207) 662-4735
(207) 662-6388
Mailing address
6 GLEN COVE DR, ROCKPORT, ME 04856-4272
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036075457
IL
2085R0202X
Diagnostic Radiology Physician
Primary
MD23752
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036075457
—
IL
05
—
1669456406
—
ME
Enumeration date
12/05/2005
Last updated
09/22/2020
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