Jeffrey M Halter, MD | |
887 Congress St, Suite 300, Portland, ME 04102 | |
(207) 662-5555 | |
(207) 662-5526 |
Full Name | Jeffrey M Halter |
---|---|
Gender | Male |
Speciality | Surgery - Pediatric Surgery |
Location | 887 Congress St, Portland, Maine |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1720297849 | NPI | - | NPPES |
30207763 | Medicaid | NH | |
432923399 | Medicaid | ME |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2086S0120X | Surgery - Pediatric Surgery | 017790 (Maine) | Secondary |
2086S0120X | Surgery - Pediatric Surgery | 35-089504 (Ohio) | Primary |
Entity Name | Maine Medical Partners |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1134144090 PECOS PAC ID: 9335043967 Enrollment ID: O20040331000191 |
Entity Name | Mainehealth |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1790265502 PECOS PAC ID: 7517860588 Enrollment ID: O20040701000166 |
Mailing Address | Practice Location Address |
---|---|
Jeffrey M Halter, MD 301 Us Route 1, Building C, Scarborough, ME 04074-9701 Ph: (207) 396-8600 | Jeffrey M Halter, MD 887 Congress St, Suite 300, Portland, ME 04102 Ph: (207) 662-5555 |
Virginia A Eddy, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 887 Congress St., Portland, ME 04102 Phone: 207-774-2311 | |
Leslie S Wu, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 887 Congress St, Suite 400, Portland, ME 04102 Phone: 207-774-6368 Fax: 207-774-9388 | |
Dr. Benjamin Lincoln Russell, DO Surgery Medicare: Medicare Enrolled Practice Location: 195 Fore River Pkwy, Suite 420, Portland, ME 04102 Phone: 207-553-6500 Fax: 207-553-6520 | |
Dr. Forest Raymond Sheppard, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 887 Congress St Ste 210, Portland, ME 04102 Phone: 207-774-6368 Fax: 207-774-9388 | |
Dr. Stacey Anne Rotta, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 887 Congress St, Portland, ME 04102 Phone: 207-774-6368 | |
Dr. Laura Teresa Withers, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 887 Congress St Ste 210, Portland, ME 04102 Phone: 207-774-2381 | |
Ms. Daly Anne Johnson, PA-C Surgery Medicare: Medicare Enrolled Practice Location: 22 Bramhall St, Portland, ME 04102 Phone: 207-662-0111 |