Graduated: 2002
NPI: 1255721627
Practice Locations (2)
INTERMED PA
100 FODEN RD
SOUTH PORTLAND, ME 041062327
2078741489
INTERMED PA
100 FODEN RD W, SUITE 100
SOUTH PORTLAND, ME 041062327
2075233900
Source: CMS National Downloadable File, September 2026.