Jeffrey B Peterson, MD | |
259 Main Street, Yarmouth, ME 04096 | |
(207) 846-9602 | |
(207) 846-6714 |
Full Name | Jeffrey B Peterson |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 259 Main Street, Yarmouth, Maine |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1700811916 | NPI | - | NPPES |
431962899 | Medicaid | ME |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 016870 (Maine) | Primary |
Entity Name | Portland Community Health Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1609120856 PECOS PAC ID: 5395998017 Enrollment ID: O20130206000120 |
Mailing Address | Practice Location Address |
---|---|
Jeffrey B Peterson, MD 100 Foden Road West, Suite 203, South Portland, ME 04106 Ph: (207) 828-0361 | Jeffrey B Peterson, MD 259 Main Street, Yarmouth, ME 04096 Ph: (207) 846-9602 |
Jennifer Power, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 45 Forest Falls Drive, Yarmouth, ME 04096 Phone: 207-846-9761 | |
Stephen B Jacobs, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 259 Main St, Yarmouth, ME 04096 Phone: 207-846-9602 Fax: 207-523-8586 | |
Erin R Van Wagenen, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 259 Main Street, Yarmouth, ME 04096 Phone: 207-846-9602 Fax: 207-662-7066 | |
Dr. Jonathan Bausman, D.O. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 259 Main St, Yarmouth, ME 04096 Phone: 207-846-9602 | |
Edward Silco, DO Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 45 Forest Falls Dr, Yarmouth, ME 04096 Phone: 207-846-9761 Fax: 207-846-9763 | |
Julia D. Lockwood, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 45 Forest Falls Drive, Yarmouth, ME 04096 Phone: 207-846-9761 |