Individual
MARK GODFREY PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-0111
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-0111
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
014988
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287880099
—
ME
Enumeration date
07/26/2005
Last updated
09/22/2021
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