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Individual

SAMUEL WOODWORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
22 BRAMHALL ST RM 2227, PORTLAND, ME 04102-3134
(207) 662-4618
Mailing address
22 BRAMHALL ST RM 2227, PORTLAND, ME 04102-3134
(207) 662-4618

Taxonomy

Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
MD22900
ME
390200000X
Student in an Organized Health Care Education/Training Program
268521
MA

Other

Enumeration date
06/13/2016
Last updated
07/16/2019
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