Individual
PETER S HEDSTROM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15 LOWELL ST, PORTLAND, ME 04102-2748
(207) 774-8277
(207) 871-1415
Mailing address
15 LOWELL ST, PORTLAND, ME 04102-2748
(207) 774-8277
(207) 871-1415
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
011295
ME
207W00000X
Ophthalmology Physician
7030
NH
Other
Enumeration date
06/23/2005
Last updated
07/08/2007
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