Provider Demographics
NPI:1417034711
Name:HALLWARD, ANNE (MD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:HALLWARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:ANNE
Other - Last Name:HALLWARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:22 FREE ST
Mailing Address - Street 2:SUITE 402
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-3960
Mailing Address - Country:US
Mailing Address - Phone:207-651-6412
Mailing Address - Fax:207-651-6412
Practice Address - Street 1:22 FREE ST
Practice Address - Street 2:SUITE 402
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-3960
Practice Address - Country:US
Practice Address - Phone:207-651-6412
Practice Address - Fax:207-773-0709
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME0157062084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
H48256Medicare UPIN
MM9049Medicare ID - Type Unspecified