Organization
RETINA CENTER OF MAINE, LLC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK WILSON BALLES MD (MD / PRACTICE OWNER)
(207) 773-3937
Entity
Organization
Contact information
Practice address
195 FORE RIVER PKWY STE 480, PORTLAND, ME 04102-2787
(207) 773-3937
(207) 773-0801
Mailing address
195 FORE RIVER PKWY STE 480, PORTLAND, ME 04102-2787
(207) 773-3937
(207) 773-0801
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
MD14047
ME
Other
Enumeration date
11/15/2007
Last updated
04/18/2017
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