Penobscot Surgical Care, P.a.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

015539 Issued in ME

Legal business name

PENOBSCOT SURGICAL CARE, P.A.

Practice address

700 Mount Hope Ave
Suite 620
Bangor, ME 04401-5691

Phone

(207) 947-1333

Fax

(207) 947-1360

NPI assigned

Jan 4, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael R Starks, M.D.

Title

President

Phone

(207) 947-1333

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124175294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 MOUNT HOPE AVE",
            "address_2": "SUITE 620",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015691",
            "telephone_number": "207-947-1333",
            "fax_number": "207-947-1360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 MOUNT HOPE AVE",
            "address_2": "SUITE 620",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015691",
            "telephone_number": "207-947-1333",
            "fax_number": "207-947-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENOBSCOT SURGICAL CARE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STARKS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-947-1333",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "ME",
            "license": "015539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Penobscot Community Health Center
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• Penobscot Respiratory
• Penobscot Valley Dermatology, P.a.
• Penquis C.a.P., Inc.
• Penquis C.a.P., Inc.
• Penquis C.a.P., Inc.
• Penquis C.a.P., Inc.

• Surgery Physician in Bangor, ME
• Providers in Bangor, ME by specialty
• Surgery Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.