Basic Information
| Provider Information | |||||||||
| NPI: | 1467726224 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KERSHNER | ||||||||
| FirstName: | DANAE | ||||||||
| MiddleName: | W | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 43 WHITING HILL RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | BREWER | ||||||||
| State: | ME | ||||||||
| PostalCode: | 044121005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2079735035 | ||||||||
| FaxNumber: | 2079735042 | ||||||||
| Practice Location | |||||||||
| Address1: | 895 UNION ST | ||||||||
| Address2: | SUITE12 | ||||||||
| City: | BANGOR | ||||||||
| State: | ME | ||||||||
| PostalCode: | 044013053 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2079737979 | ||||||||
| FaxNumber: | 2079479579 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/26/2012 | ||||||||
| LastUpdateDate: | 07/13/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 204D00000X | DO2463 | ME | N | Allopathic & Osteopathic Physicians | Neuromusculoskeletal Medicine & OMM | 207Q00000X | DO2463 | ME | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.