Organization · NPI-2

A J Candelore DO PLLC

Family Medicine · Scarborough, ME

NPI number1760859409
StatusActive
Last updated in NPPESAug 28, 2015

Details

NPI
1760859409
Entity type
Organization (NPI-2)
Legal business name
A J Candelore DO PLLC
Organization subpart
No
Enumeration date
Aug 28, 2015
Last updated
Aug 28, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine880MEYes

Practice location

617 Us Route 1
Scarborough, ME 04074-9714

Phone 207-883-5149 · Fax 207-883-7885

Mailing address

617 Us Route 1
Scarborough, ME 04074-9714

Phone 207-883-5149 · Fax 207-883-7885

Authorized official

Andrew J Candelore
Owner
2078835149

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