Basic Information
| Provider Information | |||||||||
| NPI: | 1114032562 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PARLIN | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT | ||||||||
| Address2: | PO BOX 7291 | ||||||||
| City: | LEWISTON | ||||||||
| State: | ME | ||||||||
| PostalCode: | 042437291 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2077778560 | ||||||||
| FaxNumber: | 2077778800 | ||||||||
| Practice Location | |||||||||
| Address1: | 235 HIGH ST | ||||||||
| Address2: | |||||||||
| City: | ELLSWORTH | ||||||||
| State: | ME | ||||||||
| PostalCode: | 046051715 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2074125200 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2006 | ||||||||
| LastUpdateDate: | 02/03/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD18425 | ME | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 46469 | CO | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | A77047 | CA | N | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.