Individual
DR. VILLI PETERS ENDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
53 SEWALL ST, PORTLAND, ME 04102-2625
(207) 828-2020
Mailing address
PO BOX 810, WESTBROOK, ME 04098-0810
(207) 854-1544
(207) 854-1516
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
012829
ME
207L00000X
Anesthesiology Physician
147526-1
NY
207L00000X
Anesthesiology Physician
MD-052485-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006187
ANTHEM OF MAINE
ME
01
—
1740263433
INDIVIDUAL NPI
ME
05
—
218470000
—
ME
Enumeration date
11/28/2005
Last updated
03/26/2009
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