Kiefner, Mark Gregory

Kiefner, Mark Gregory is an individual health care provider with primary practice located at 26 Portland Street , Portland ME 04101. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as his primary health care specialty. Kiefner, Mark Gregory can be contacted via phone (207) 761-8402.

Contact Information

Primary practice address
26 Portland Street Portland ME 04101
Phone: (207) 761-8402
Fax: (207) 761-8405
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X PS815 Maine

Profile Details

NPI number 1346457017
LBN Legal business name Kiefner, Mark Gregory
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346457017 NPPES
Maine Other 010593 ANTHEM

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