Provider Demographics
NPI:1902987506
Name:BANGOR PLASTIC AND HAND SURGERY, P.A.
Entity Type:Organization
Organization Name:BANGOR PLASTIC AND HAND SURGERY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRANCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:207-947-5657
Mailing Address - Street 1:885 UNION ST
Mailing Address - Street 2:SUITE 245
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3083
Mailing Address - Country:US
Mailing Address - Phone:207-947-5657
Mailing Address - Fax:207-947-1894
Practice Address - Street 1:885 UNION ST
Practice Address - Street 2:SUITE 245
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3083
Practice Address - Country:US
Practice Address - Phone:207-947-5657
Practice Address - Fax:207-947-1894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Single Specialty