Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD18219 | ME |
N | 111NI0900X | Internist | MD18219 | ME |
Y | 207RG0300X | Geriatric Medicine | MD18219 | ME |
NPI | 1033221817 |
---|---|
Provider Name | Sarah A. M. Hallen |
First Address | Scarborough, ME 04074-9701 |
Second Address | Portland, ME 04102-3344 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 04/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30208912 | (05) | NH |
434507199 | (05) | ME |