Individual
ADAM BURCHARD SISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
53 SEWALL ST, PORTLAND, ME 04102-2625
(207) 828-2020
Mailing address
53 SEWALL ST, PORTLAND, ME 04102-2625
(207) 828-2020
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD20477
ME
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2010
Last updated
11/25/2024
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