Organization Name: | MAINE MEDICAL PARTNERS |
NPI Number: | 1144245028 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STEPHEN J KASABIAN (PRESIDENT) |
Mailing Address: | 584 Roosevelt Trl Windham |
State: | ME US |
Postal Code: | 040624904 |
Phone Number: | 2078923233 |
Fax Number: | |
NPI Enumeration Date: | 07/13/2006 |
NPI Last Update Date: | 05/02/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |