Provider Demographics
NPI:1104994805
Name:WADLAND, KATHRYN G (MD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:G
Last Name:WADLAND
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Gender:F
Credentials:MD
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Mailing Address - Street 1:195 FORE RIVER PKWY
Mailing Address - Street 2:SUITE 440
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-2780
Mailing Address - Country:US
Mailing Address - Phone:207-553-6920
Mailing Address - Fax:207-553-6940
Practice Address - Street 1:195 FORE RIVER PKWY
Practice Address - Street 2:SUITE 440
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-2780
Practice Address - Country:US
Practice Address - Phone:207-553-6920
Practice Address - Fax:207-553-6940
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2012-02-21
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Provider Licenses
StateLicense IDTaxonomies
ME017376207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME001287402Medicare PIN