Alexander Babaoghli, DO

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Lewiston, ME

NPI 1336724301 · NPPES record last updated Mar 22, 2023

Key facts

NPI
1336724301
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
76 High St
Lewiston, ME 04240-7649
Phone
(207) 795-2805
NPI assigned
Mar 11, 2021
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240903003306 ME Order and Referring Only - Family Practice
Practitioner - Family Practice
3779022827

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

76 High St
Lewiston, ME 04240-7649

Mailing address

76 High St
Lewiston, ME 04240-7649
Phone (207) 795-2805

Other providers in Lewiston, ME

All providers in Lewiston, ME · Student in an Organized Health Care Education/Training Program in Maine

Sources for this page

Verify at the official NPI Registry.