Individual
HEIDI M LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2 GREAT FALLS PLZ STE 21, AUBURN, ME 04210-5966
(207) 330-3950
(207) 330-3955
Mailing address
161 CORPORATE DR, PORTSMOUTH, NH 03801-6825
(603) 431-5154
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD14388
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046529
ANTHEM
ME
05
—
3 5150000
—
ME
01
—
5904624
AETNA
ME
Enumeration date
08/21/2006
Last updated
06/11/2020
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