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Individual

DR. DALE R GOWEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
331 VERANDA ST, PORTLAND, ME 04103-5545
(207) 774-5801
Mailing address
PO BOX 9746, PORTLAND, ME 04104-5040

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
017182
ME

Other

Enumeration date
07/12/2006
Last updated
07/08/2007
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