Individual
JOHN D. BANCROFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
887 CONGRESS ST, SUITE 410B, PORTLAND, ME 04102-3100
(207) 523-3289
(207) 761-8198
Mailing address
301 US ROUTE 1, BUILDING C, SCARBOROUGH, ME 04074-7609
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
014200
ME
2080P0206X
Pediatric Gastroenterology Physician
Primary
014200
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30009613
—
NH
05
—
330460099
—
ME
Enumeration date
06/28/2006
Last updated
01/03/2011
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