Active NPI
Sebasticook Medical Specialists
- Surgery Physician
- Bangor, ME
National Provider Identifier
1295905271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- Legal business name
- SEBASTICOOK MEDICAL SPECIALISTS
- Practice address
- 470 State Street
Suite 210
Bangor, ME 04401 - Phone
- (207) 973-4878
- NPI assigned
- Mar 6, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Emily Edgar
- Title
- Director of Patient Accounts
- Phone
- (207) 487-0916
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | Primary |
Addresses
Primary practice location
470 State Street
Suite 210
Bangor, ME 04401
Mailing address
PO Box 810
Westbrook, ME 04098-0810
Phone (207) 854-1544
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HX3558 | Other | ME | MEDICARE INDIVIDUAL NUMBE |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204761600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1204761600000",
"number": "1295905271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 810",
"city": "WESTBROOK",
"state": "ME",
"postal_code": "040980810",
"telephone_number": "207-854-1544",
"fax_number": "207-854-1516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "470 STATE STREET",
"address_2": "SUITE 210",
"city": "BANGOR",
"state": "ME",
"postal_code": "04401",
"telephone_number": "207-973-4878"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SEBASTICOOK MEDICAL SPECIALISTS",
"organizational_subpart": "NO",
"enumeration_date": "2008-03-06",
"last_updated": "2008-03-06",
"status": "A",
"authorized_official_last_name": "EDGAR",
"authorized_official_first_name": "EMILY",
"authorized_official_title_or_position": "DIRECTOR OF PATIENT ACCOUNTS",
"authorized_official_telephone_number": "207-487-0916"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE INDIVIDUAL NUMBE",
"identifier": "HX3558",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bangor, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.