Individual
BRIAN BAO LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
489 STATE ST, BANGOR, ME 04401-6616
(207) 973-4519
(207) 992-4132
Mailing address
51 HARBORSIDE RD, HARBORSIDE, ME 04642-3003
(207) 992-4032
(207) 992-4034
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
51629
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME183803
MEDICARE P-TAN FOR BHMH
ME
Enumeration date
08/19/2006
Last updated
01/03/2022
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