Organization
KENNEBEC VALLEY OBSTETRICS & GYNECOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK S. COOPER M.D. (PRESIDENT)
(207) 623-1322
Entity
Organization
Contact information
Practice address
5 CALDWELL RD, AUGUSTA, ME 04330-5739
(207) 623-1322
Mailing address
5 CALDWELL RD, AUGUSTA, ME 04330-5739
(207) 623-1322
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3173496
CIGNA
ME
01
—
C0101
ANTHEM
ME
Enumeration date
01/06/2006
Last updated
08/22/2020
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