Mainehealth
Organization Active NPI Pulmonary Disease Physician · Portland, ME
NPI 1992065080 · NPPES record last updated May 11, 2020
Key facts
- NPI
- 1992065080
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pulmonary Disease Physician 207RP1001X
- Legal business name
- MAINEHEALTH
- Practice address
- 22 Bramhall St
Portland, ME 04102 - Phone
- (207) 662-0111
- NPI assigned
- May 22, 2012
- Organization subpart
- Yes
- Parent organization (as reported)
- MAINEHEALTH
Authorized official
- Name
- Lugene Anthony Inzana
- Title
- Associate Cfo
- Phone
- (207) 662-3538
Corporate family (same tax ID) 13
National Provider Directory
- Tax ID family
- Maine Medical Assoc
- Part of
- Maine Medical Assoc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician |
207RP1001X | Yes |
Addresses
Primary practice location
22 Bramhall St
Portland, ME 04102
Mailing address
301C US Route 1
Scarborough, ME 04074-9701
Phone (207) 396-8600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30212545 | Medicaid | NH |
Other names
- MMC CF Clinic
Other providers in Portland, ME
- Mainehealth
- Mainehealth
- Mainehealth
- Mainehealth
- Mainehealth
- Mainely Nutrition LLC
- Mainely Smiles
- Mainerscare LLC
- Mainetouch
- Kenneth Maisak
All providers in Portland, ME · Pulmonary Disease 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 11, 2020. 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.