| Organization Name: | FORE RIVER UROLOGY LLC |
| NPI Number: | 1003248436 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MEGAN SHOREY (OFFICE MANAGER) |
| Mailing Address: | 21 Donald B Dean Dr Suite 1 South Portland |
| State: | ME US |
| Postal Code: | 041063252 |
| Phone Number: | 2077762411 |
| Fax Number: | |
| NPI Enumeration Date: | 08/08/2013 |
| NPI Last Update Date: | 08/08/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2088F0040X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Urology |
| Taxonomy Specialization: | Female Pelvic Medicine and Reconstructive Surgery |
| Taxonomy Definition: | A subspecialist in Female Pelvic Medicine and Reconstructive Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education and training, is prepared to provide consultation and comprehensive management of women with complex benign pelvic conditions, lower urinary tract disorders, and pelvic floor dysfunction. Comprehensive management includes those diagnostic and therapeutic procedures necessary for the total care of the patient with these conditions and complications resulting from them. |