Basic Information
| Provider Information | |||||||||
| NPI: | 1336363951 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EMERY | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | DEVLIN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 SOUTHBOROUGH DR | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | SOUTH PORTLAND | ||||||||
| State: | ME | ||||||||
| PostalCode: | 041066914 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2076612000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1577 CONGRESS ST | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | ME | ||||||||
| PostalCode: | 041022169 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2076621442 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2007 | ||||||||
| LastUpdateDate: | 08/18/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MD2010-0477 | NM | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 15293 | NH | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | MD20870 | ME | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.