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Individual

JOHN F, KWOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-0111
Mailing address
324 GANNETT DR STE 200, SOUTH PORTLAND, ME 04106-3266
(207) 482-7800
(207) 956-6676

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
0101258504
VA
207L00000X
Anesthesiology Physician
Primary
MD21754
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1730479122
ME
Enumeration date
04/19/2011
Last updated
07/21/2022
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