Provider Demographics
NPI:1902958978
Name:ROSALIND R WALDRON MD
Entity Type:Organization
Organization Name:ROSALIND R WALDRON MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ROSALIND
Authorized Official - Middle Name:R
Authorized Official - Last Name:WALDRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:207-872-5139
Mailing Address - Street 1:15 BAY ST
Mailing Address - Street 2:
Mailing Address - City:WINSLOW
Mailing Address - State:ME
Mailing Address - Zip Code:04901-7045
Mailing Address - Country:US
Mailing Address - Phone:207-872-5139
Mailing Address - Fax:207-861-5460
Practice Address - Street 1:15 BAY ST
Practice Address - Street 2:
Practice Address - City:WINSLOW
Practice Address - State:ME
Practice Address - Zip Code:04901-7045
Practice Address - Country:US
Practice Address - Phone:207-872-5139
Practice Address - Fax:207-861-5460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty