Larson, Jean M

Larson, Jean M is an individual health care provider with primary practice located at 417 State St Ste 121 , Bangor ME 04401-6630. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Gastroenterology is her primary health care specialty. Larson, Jean M can be contacted via phone (207) 973-4266.

Contact Information

Primary practice address
417 State St Ste 121 Bangor ME 04401-6630
Phone: (207) 973-4266
Fax: (207) 973-5151
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME100673 Florida
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 018950 Maine

Profile Details

NPI number 1033206941
LBN Legal business name Larson, Jean M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2006
Last updated Feb 28th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033206941 NPPES
Florida MEDICAID 280216300
Florida MEDICAID 1033206941

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