Casco Bay Gastroenterology LLC
Organization Active NPI Gastroenterology Physician · South Portland, ME
NPI 1972579241 · NPPES record last updated May 7, 2008
Key facts
- NPI
- 1972579241
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Gastroenterology Physician 207RG0100X
- Legal business name
- CASCO BAY GASTROENTEROLOGY LLC
- Practice address
- 25 Long Creek Dr
South Portland, ME 04106-2440 - Phone
- (207) 879-0094
- Fax
- (207) 879-0095
- NPI assigned
- Feb 27, 2006
- Organization subpart
- No
Authorized official
- Name
- Christine Marie Daigle, CCP
- Title
- Billing Manager
- Phone
- (207) 879-0094
Practitioners 11
-
Jennifer Rebecca Blastow, NP-C
-
Russell S Dumond, CRNA
-
Stuart Eisenberg, MD
-
Pamela Ryder Fox, APRN.FNP
-
Annette Haley, CRNA
-
Jaime Hare, FNP-C
-
Susan J Morley, FNP-C
-
Michelle True, FNP-C
-
Kimberly E Pollis, FNP-C
-
Carol A Ryder Foley, FNP-C
-
Harold Hayes Sullivan Jr., MD, MPH
National Provider Directory
Locations
25 Long Creek Dr
#B
South Portland, ME 04106
Phone (207) 879-0094
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician |
207RG0100X | Yes |
Addresses
Primary practice location
25 Long Creek Dr
South Portland, ME 04106-2440
Mailing address
25 Long Creek Dr
South Portland, ME 04106-2440
Phone (207) 879-0094
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DC0798 | Other | ME | RAILROAD MEDICARE |
| 126510000 | Medicaid | ME |
Other providers in South Portland, ME
- Casco Bay Ambulance Service Inc
- Casco Bay Direct Primary Care
- Casco Bay Endoscopy
- Casco Bay Eyecare LLC
- Casco Bay Eyecare LLC
- Casco Bay Infusion, LLC
- Tammy Martin Casey
- Clara Cassidy
- Haley Elizabeth Castonguay
- Todd Castonguay
All providers in South Portland, 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 May 7, 2008. 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.