Individual
KATHRYN WISTAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
47 MAIN ST, COOPERS MILLS, ME 04341
(207) 549-7581
(207) 549-3439
Mailing address
PO BOX 207, COOPERS MILLS, ME 04341
(207) 549-7581
(207) 549-3439
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
017250
ME
Other
Enumeration date
10/05/2006
Last updated
05/04/2010
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