Bangor Surgical Associates, P.a.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

1149 Issued in ME

Legal business name

BANGOR SURGICAL ASSOCIATES, P.A.

Practice address

358 Broadway
Suite 306
Bangor, ME 04401-3929

Phone

(207) 947-5503

Fax

(207) 947-8578

NPI assigned

Dec 9, 2005

Last updated

Dec 15, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John F Vanadia, D.O.

Title

Owner/President

Phone

(207) 947-5503

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292371200000",
    "number": "1881679116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "358 BROADWAY",
            "address_2": "SUITE 306",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013929",
            "telephone_number": "207-947-5503",
            "fax_number": "207-947-8578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "358 BROADWAY",
            "address_2": "SUITE 306",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013929",
            "telephone_number": "207-947-5503",
            "fax_number": "207-947-8578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANGOR SURGICAL ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-09",
        "last_updated": "2010-12-15",
        "status": "A",
        "authorized_official_last_name": "VANADIA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "207-947-5503",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ME",
            "license": "1149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER NUMBER",
            "identifier": "2677016",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BS PROVIDER #",
            "identifier": "040754",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134040000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bangor Healthcare
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• Bangor Plastic and Hand Surgery, P.a.
• Bangor Psychiatric Associates, PA
• Emily Banks, DPT
• Elizabeth Ann Baratta, MD
• Erin Barker, FNP
• Olivia Paige Barksdale, PA-C
• Sean Barnett, M.D.

• Surgery Physician in Bangor, ME
• Providers in Bangor, ME by specialty
• Surgery Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2010; 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.