Provider Demographics
NPI:1942567359
Name:MAZORRA, MARIA E (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:E
Last Name:MAZORRA
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 1:700 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:ME
Mailing Address - Zip Code:04530-2574
Mailing Address - Country:US
Mailing Address - Phone:207-442-4618
Mailing Address - Fax:207-442-3386
Practice Address - Street 1:700 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:ME
Practice Address - Zip Code:04530-2574
Practice Address - Country:US
Practice Address - Phone:207-442-4618
Practice Address - Fax:207-442-3386
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME013266207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine