Organization
MAURICE R GARDNER DPM PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAURICE R. GARDNER DPM (OWNER)
(207) 784-2042
Entity
Organization
Contact information
Practice address
681 SABATTUS ST, LEWISTON, ME 04240-3829
(207) 784-2042
Mailing address
681 SABATTUS ST, LEWISTON, ME 04240-3829
(207) 784-2042
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121590000
—
ME
Enumeration date
01/08/2007
Last updated
06/23/2008
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