Individual
MARY W TIBBETTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6 E CHESTNUT ST, AUGUSTA, ME 04330-5717
(207) 626-1275
(207) 626-1985
Mailing address
6 E CHESTNUT ST, AUGUSTA, ME 04330-5717
(207) 626-1275
(207) 621-1985
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
017199
ME
Other
Enumeration date
10/05/2005
Last updated
07/07/2008
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