Micheal Akinboro, MD

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

NPI 1720822018 · NPPES record last updated Jul 9, 2024

Key facts

NPI
1720822018
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
License
EC241056 (ME)
Practice address
15 E Chestnut St
Augusta, ME 04330-5736
Phone
(207) 626-1561
Fax
(207) 626-1849
NPI assigned
Jun 21, 2024
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
I20240912003603 ME Order and Referring Only - Family Practice
Practitioner - Family Practice
1759821010

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Interoperability endpoints

  • Direct secure messaging: michealakinboro@mgh.allscriptsdirect.net

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X EC241056 ME Yes

Addresses

Primary practice location

15 E Chestnut St
Augusta, ME 04330-5736

Mailing address

15 E Chestnut St
Augusta, ME 04330-5736
Phone (207) 626-1561

Other providers in Augusta, ME

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

Sources for this page

Verify at the official NPI Registry.