Individual
EDEN J. ZOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
208 VAUGHAN ST, PORTLAND, ME 04102-3204
(207) 221-2355
(207) 221-2356
Mailing address
PO BOX 4022, PORTLAND, ME 04101-0222
(207) 221-2355
(207) 221-2356
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
1715
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100376
ANTHEM BLUE CROSS BLUE SH
ME
Enumeration date
05/19/2006
Last updated
09/21/2011
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