Individual
KENNETH MAISAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
68 MARGINAL WAY, PORTLAND, ME 04101-2444
(207) 879-1339
(207) 879-1092
Mailing address
68 MARGINAL WAY, PORTLAND, ME 04101-2444
(207) 879-1339
(207) 879-1092
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD1077
ME
Other
Enumeration date
02/02/2009
Last updated
09/05/2012
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