Individual
WILLIAM C ERVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
84 MARGINAL WAY, SUITE 700, PORTLAND, ME 04101-2443
(207) 774-5816
(207) 523-8597
Mailing address
100 FODEN ROAD WEST, SUITE 203, SOUTH PORTLAND, ME 04106
(207) 828-0361
(207) 874-1483
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
009853
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010556
ANTHEM
—
01
—
1044610
AETNA
—
05
—
238590099
—
ME
Enumeration date
03/18/2006
Last updated
11/17/2010
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