Individual
JANESE SHADE' LASTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
417 STATE ST STE 121, BANGOR, ME 04401-6630
(207) 973-4266
Mailing address
43 WHITING HILL RD STE 300, BREWER, ME 04412-1006
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
296806
NY
207RG0100X
Gastroenterology Physician
Primary
MD23165
ME
Other
Enumeration date
04/10/2012
Last updated
10/22/2020
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