Provider Demographics
NPI:1891897435
Name:PARKER, JANET M (MD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:M
Last Name:PARKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 BANGOR ST STE 3
Mailing Address - Street 2:
Mailing Address - City:HOULTON
Mailing Address - State:ME
Mailing Address - Zip Code:04730-1740
Mailing Address - Country:US
Mailing Address - Phone:207-532-7161
Mailing Address - Fax:207-532-1090
Practice Address - Street 1:59 BANGOR ST STE 3
Practice Address - Street 2:
Practice Address - City:HOULTON
Practice Address - State:ME
Practice Address - Zip Code:04730-1740
Practice Address - Country:US
Practice Address - Phone:207-532-7161
Practice Address - Fax:207-532-1090
Is Sole Proprietor?:No
Enumeration Date:2006-09-03
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME009206207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME265100099Medicaid
MED0152576Medicare ID - Type Unspecified
ME265100099Medicaid