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Organization

WATERVILLE PEDIATRICS PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEFFREY STONE D.O. (TREASURER)
(207) 873-5437
Entity
Organization

Contact information

Practice address
295C KENNEDY MEMORIAL DR, WATERVILLE, ME 04901-4535
(207) 873-5437
(207) 872-6037
Mailing address
295C KENNEDY MEMORIAL DR, WATERVILLE, ME 04901-4535
(207) 873-5437
(207) 872-6037

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
1317
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000206014
ME
01
129440000
MAINECARE PROVIDER NO.
ME
Enumeration date
10/05/2006
Last updated
04/02/2021
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