| Doctor Name: | DR. EDWARD Z. WALWORTH |
| NPI Number: | 1023004496 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | |
| Business Practice Address: | 710 Main St Lewiston, ME - 042405801 |
| Business Phone Number: | 2077831449 |
| Business Fax Number: | 2077773865 |
| Mailing Address: | Po Box 4157, St. Mary's Health System BOSTON |
| State: | MH |
| Postal Code: | 022114157 |
| Phone Number: | 2077774111 |
| Fax Number: | 2077836660 |
| NPI Enumeration Date: | 09/21/2005 |
| NPI Last Update Date: | 01/28/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |