Individual
MARY E TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1012 UNION ST, BANGOR, ME 04401-3060
(207) 945-5247
(207) 990-1248
Mailing address
1048 UNION ST, SUITE 5, BANGOR, ME 04401-8600
(207) 945-5247
(207) 992-2154
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA001165
ME
363AM0700X
Medical Physician Assistant
Primary
PA001165
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
434193199
—
ME
Enumeration date
06/05/2009
Last updated
06/05/2009
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