Active NPI
David Walter Edsall, MD ANESTHESIOLOGIST
- Anesthesiology Physician
- Bangor, ME
National Provider Identifier
1992808158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 011281
- Practice address
- 489 State St
Bangor, ME 04401-6616 - Phone
- (207) 973-7000
- Fax
- (207) 973-5042
- NPI assigned
- Sep 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 011281 | ME | Primary |
Addresses
Primary practice location
489 State St
Bangor, ME 04401-6616
Mailing address
43 Whiting Hill Rd Ste 33
Brewer, ME 04412-1005
Phone (207) 973-5035
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011281 | ME | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Norumbega Medical Specialists, LTD | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Health Service Clinic/Center
- Brewer, ME
- NPI 1780821140
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207008000000",
"number": "1992808158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43 WHITING HILL RD STE 33",
"city": "BREWER",
"state": "ME",
"postal_code": "044121005",
"telephone_number": "207-973-5035",
"fax_number": "207-973-5042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "489 STATE ST",
"city": "BANGOR",
"state": "ME",
"postal_code": "044016616",
"telephone_number": "207-973-7000",
"fax_number": "207-973-5042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDSALL",
"first_name": "DAVID",
"middle_name": "WALTER",
"name_prefix": "Dr.",
"credential": "MD ANESTHESIOLOGIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-06",
"last_updated": "2008-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "ME",
"license": "011281",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bangor, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.