| Mmc Family Practice Residency Program | |
|
272 Congress St Portland ME 04102 | |
| (207) 874-2466 | |
| (207) 774-4625 |
| Full Name | Mmc Family Practice Residency Program |
|---|---|
| Speciality | Family Medicine |
| Location | 272 Congress St, Portland, Maine |
| Authorized Official Name and Position | Lugene Anthony Inzana (SVP FINANCE/CFO) |
| Authorized Official Contact | 2076623538 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mmc Family Practice Residency Program 301c Us Route 1 Scarborough ME 04074-9701 Ph: (207) 396-8600 | Mmc Family Practice Residency Program 272 Congress St Portland ME 04102 Ph: (207) 874-2466 |
| NPI Number | 1225232606 |
|---|---|
| Provider Enumeration Date | 06/12/2007 |
| Last Update Date | 04/24/2020 |
| Certification Date | 04/24/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225232606 | NPI | - | NPPES |
| 30216370 | Medicaid | NH |
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