OrganizationActive
Evernorth Care Providers - Delaware PA
NPI 1023840386 · General Practice Physician · Bangor, ME
Provider details
- NPI number
- 1023840386
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Grace Blue, Credentialing Sr. Manager(773) 292-4800
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
700 Main St Ste 3
Bangor, ME 04401-6800
Phone: (773) 292-4800
Fax: (773) 564-4059
Approximate (ZIP-level) locationGet directions
Mailing address
730 Cool Springs Blvd Ste 500
Franklin, TN 37067-7331
Registry dates
- Enumerated
- 2024-08-15
- Last updated
- 2024-08-15
- Certified
- 2024-08-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.