| Maine Functional Medicine | |
| 33 Penn Plz Ste A Bangor ME 04401-3619 | |
| (207) 941-0080 | |
| (207) 941-0093 | 
| Full Name | Maine Functional Medicine | 
|---|---|
| Speciality | Family Medicine | 
| Location | 33 Penn Plz Ste A, Bangor, Maine | 
| Authorized Official Name and Position | Kelly Drake (OFFICE MANAGER) | 
| Authorized Official Contact | 2079410080 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Maine Functional Medicine 33 Penn Plz Ste A Bangor ME 04401-3619 Ph: (207) 941-0080 | Maine Functional Medicine 33 Penn Plz Ste A Bangor ME 04401-3619 Ph: (207) 941-0080 | 
| NPI Number | 1427512904 | 
|---|---|
| Provider Enumeration Date | 01/29/2019 | 
| Last Update Date | 01/29/2019 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1427512904 | NPI | - | NPPES | 
| 1053336206 | Other | ME | NPI | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary | 
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