Individual
RICHARD A BAZARIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
161 MARGINAL WAY, PORTLAND, ME 04101-2438
(207) 774-8277
Mailing address
15 LOWELL ST, PORTLAND, ME 04102-2748
(207) 774-8277
(207) 699-5850
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
014067
ME
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
MD14067
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292590099
—
ME
Enumeration date
06/28/2005
Last updated
10/12/2023
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