Provider Demographics
NPI:1790955730
Name:CLINTON, GAIL ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:ELIZABETH
Last Name:CLINTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10 FORECASTER WAY
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074
Mailing Address - Country:US
Mailing Address - Phone:207-409-8878
Mailing Address - Fax:207-477-7323
Practice Address - Street 1:10 FORECASTER WAY
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-7176
Practice Address - Country:US
Practice Address - Phone:207-409-8878
Practice Address - Fax:207-477-7323
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG856542084P0800X
ME0141352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry