Stuart Eisenberg, MD
Individual provider Active NPI Gastroenterology Physician · Bridgton, ME
NPI 1619947249 · NPPES record last updated Aug 17, 2010
Key facts
- NPI
- 1619947249
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gastroenterology Physician 207RG0100X
- License
- 016650 (ME)
- Practice address
- 15 Hospital Dr
Bridgton, ME 04009-1156 - Phone
- (207) 647-6240
- Fax
- (207) 647-6223
- NPI assigned
- Jan 25, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016650 | ME | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Casco Bay Endoscopy | Past | Accepting new patients | |
| Casco Bay Gastroenterology LLC | Gastroenterology | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 016650 | ME | Yes |
Addresses
Primary practice location
15 Hospital Dr
Bridgton, ME 04009-1156
Mailing address
15 Hospital Dr
Bridgton, ME 04009-1156
Phone (207) 647-6240
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 415690099 | Medicaid | ME | |
| 432706124 | Medicaid | ME | |
| DC0798 | Other | ME | RAILROAD MEDICARE |
Other providers in Bridgton, ME
- Amy Donatelli
- Kayla Rey Dubois
- Jacqueline Marie Dubord
- Olivia Ducasse
- Derek M Eagan
- Leslie Ann Elston
- Edward Enos
- Heidi Beth Fillmore
- John J Flanagan
- Brittany Brown Flanders
All providers in Bridgton, ME · Gastroenterology Physician in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.