Individual
JOHN B WAHLIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
195 FORE RIVER PKWY, SUITE 490, PORTLAND, ME 04102-2780
(207) 553-6054
(207) 553-6076
Mailing address
195 FORE RIVER PKWY, SUITE 490, PORTLAND, ME 04102-2780
(207) 553-6054
(207) 553-6076
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
MD16536
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30204407
—
NH
05
—
410600099
—
ME
Enumeration date
06/16/2006
Last updated
12/12/2013
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