Provider Demographics
NPI:1942575345
Name:LOMMLER, ELMER HAROLD (MD)
Entity Type:Individual
Prefix:DR
First Name:ELMER
Middle Name:HAROLD
Last Name:LOMMLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 FRENCH ST
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-5064
Mailing Address - Country:US
Mailing Address - Phone:207-922-4006
Mailing Address - Fax:207-922-4051
Practice Address - Street 1:205 FRENCH ST
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-5064
Practice Address - Country:US
Practice Address - Phone:207-922-4006
Practice Address - Fax:207-922-4051
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME9862207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine