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Organization

GORHAM PRIMARY CARE PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ANDREW STUART NICHOLSON M.D. (DIRECT/INDIRECT OWNER)
(207) 839-5551
Entity
Organization

Contact information

Practice address
130 MAIN ST, GORHAM, ME 04038-1319
(207) 839-5551
(207) 839-5573
Mailing address
130 MAIN ST, GORHAM, ME 04038-1319
(207) 839-5551
(207) 839-5573

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
015480
ME

Other

Enumeration date
05/21/2008
Last updated
07/15/2008
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