Individual
DR. DIANE MARIE KIDRIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O., J.D.
Contact information
Practice address
324 GANNETT DR STE 200, SOUTH PORTLAND, ME 04106-3266
(207) 482-7800
Mailing address
324 GANNETT DR STE 200, SOUTH PORTLAND, ME 04106-3266
(207) 482-7861
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
2012-00949
NC
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
DO2424
ME
Other
Enumeration date
07/25/2007
Last updated
03/31/2018
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