NPI 1982750659 · live from the CMS NPI Registry
Edward B Jernigan, MD
Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology in Bangor, ME. National Provider Identifier 1982750659, active.
NPI record
| NPI | 1982750659 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology 2084N0402X |
| Practice location | 133 Corporate Dr, Bangor, ME 04401 |
| Practice phone | 207-275-4290 |
| Mailing address | 43 Whiting Hill Rd, Suite 300, Brewer, ME 04412 |
| Enumerated | January 26, 2007 |
| Last updated | August 17, 2017 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology | 2084N0402X | M10765 (ID) |
| Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology primary | 2084N0402X | MD20913 (ME) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.