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Individual

MICHAEL STADNICKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
12 HIGH ST, STE 302, LEWISTON, ME 04240-7634
(207) 795-5709
(207) 795-5649
Mailing address
12 HIGH ST, STE 302, LEWISTON, ME 04240-7634
(207) 795-5750
(207) 795-5649

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
016038
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010211494
ME
Enumeration date
01/18/2006
Last updated
09/15/2011
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