Macklin & Ervin Mdpa

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

010650 Issued in ME

Legal business name

MACKLIN & ERVIN MDPA

Practice address

2 School St
Waterville, ME 04901-7518

Phone

(207) 873-6183

Fax

(207) 861-5457

NPI assigned

Nov 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Edmund Dole Ervin, MD

Title

Owner

Phone

(207) 873-6183

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194480000000",
    "number": "1598945321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SCHOOL ST",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049017518",
            "telephone_number": "207-873-6183",
            "fax_number": "207-861-5457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SCHOOL ST",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049017518",
            "telephone_number": "207-873-6183",
            "fax_number": "207-861-5457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACKLIN & ERVIN MDPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-08",
        "last_updated": "2007-11-08",
        "status": "A",
        "authorized_official_last_name": "ERVIN",
        "authorized_official_first_name": "EDMUND",
        "authorized_official_middle_name": "DOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-873-6183",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "010650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107850099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joanna Damen Lusk-Libby, APRN-BC
• Whitney Glyn Lutz, CPNP
• Nichole Marie Lyford, APRN-CNP
• Dana Lyon, FNP
• Pamela Mae Lyon, NP
• Josefina Madero, MD
• Samuel Madore, DO
• Patricia Mahoney-Rohrl, LCSW
• Rachel Maier
• Maine Comprehensive Health Institute

• Internal Medicine Physician in Waterville, ME
• Providers in Waterville, ME by specialty
• Internal Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; 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.