| Mmp Family Medicine | |
|
272 Congress St Portland ME 04101 | |
| (207) 874-2466 | |
| (207) 774-4625 |
| Full Name | Mmp Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 272 Congress St, Portland, Maine |
| Authorized Official Name and Position | Lugene Anthony Inzana (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 2076623538 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mmp Family Medicine 300 Southborough Dr Suite 201 South Portland ME 04106-6914 Ph: (207) 661-2000 | Mmp Family Medicine 272 Congress St Portland ME 04101 Ph: (207) 874-2466 |
| NPI Number | 1639194509 |
|---|---|
| Provider Enumeration Date | 07/13/2006 |
| Last Update Date | 12/19/2022 |
| Certification Date | 12/19/2022 |
| Medicare PECOS PAC ID | 7517860588 |
|---|---|
| Medicare Enrollment ID | O20040206000472 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639194509 | NPI | - | NPPES |
| 30216370 | Medicaid | NH | |
| 102500200 | Medicaid | ME | |
| 102500202 | Medicaid | ME | |
| 102500000 | Medicaid | ME |
| Provider Name | Alison M Samitt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336242585 PECOS PAC ID: 0648184671 Enrollment ID: I20031114000206 |
| Provider Name | Joseph T Degrinney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538106679 PECOS PAC ID: 2567355852 Enrollment ID: I20040202000986 |
| Provider Name | Stephen J Kirsch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093747628 PECOS PAC ID: 7416851043 Enrollment ID: I20040206000603 |
| Provider Name | Jeffrey J Aalberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669400222 PECOS PAC ID: 4981593860 Enrollment ID: I20040312000277 |
| Provider Name | Julie M Schirmer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699872143 PECOS PAC ID: 9335131382 Enrollment ID: I20040331001012 |
| Provider Name | Christina T Holt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912935339 PECOS PAC ID: 3779574579 Enrollment ID: I20040520000859 |
| Provider Name | Lisa M Belisle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629131685 PECOS PAC ID: 0446231591 Enrollment ID: I20040526000161 |
| Provider Name | Ralph W Thieme |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1710963434 PECOS PAC ID: 9638150048 Enrollment ID: I20040601000023 |
| Provider Name | Nicole Cherbuliez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932293578 PECOS PAC ID: 0840277455 Enrollment ID: I20040701000907 |
| Provider Name | Jacey E Goddard |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1073569216 PECOS PAC ID: 8224008784 Enrollment ID: I20040730000602 |
| Provider Name | Richard T Marino |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1285665828 PECOS PAC ID: 1557332665 Enrollment ID: I20040803000815 |
| Provider Name | Cindy E Pepper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104867290 PECOS PAC ID: 9335112259 Enrollment ID: I20040818000183 |
| Provider Name | Mark P Bouchard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023040656 PECOS PAC ID: 2567436264 Enrollment ID: I20040819001113 |
| Provider Name | Karen L Roberts |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1366467508 PECOS PAC ID: 4183692585 Enrollment ID: I20040923000306 |
| Provider Name | Katherine A Gilbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154390847 PECOS PAC ID: 2567427537 Enrollment ID: I20041201000688 |
| Provider Name | Christine M Freme |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225123524 PECOS PAC ID: 6507807674 Enrollment ID: I20050518001203 |
| Provider Name | Craig D Schneider |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992808133 PECOS PAC ID: 4587606678 Enrollment ID: I20050531000263 |
| Provider Name | Eric Mukai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750310611 PECOS PAC ID: 4284677097 Enrollment ID: I20050602000841 |
| Provider Name | Cindy Boyack |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558470781 PECOS PAC ID: 5698718278 Enrollment ID: I20050606000039 |
| Provider Name | William W Dexter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396739520 PECOS PAC ID: 2365485687 Enrollment ID: I20050608000198 |
| Provider Name | Debra A Rothenberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245265776 PECOS PAC ID: 7810930963 Enrollment ID: I20050609000112 |
| Provider Name | Christopher A Wellins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053407601 PECOS PAC ID: 5991749897 Enrollment ID: I20050613000188 |
| Provider Name | Charles M Belisle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932144151 PECOS PAC ID: 5395789200 Enrollment ID: I20050613000306 |
| Provider Name | Michael R Stadnicki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831179803 PECOS PAC ID: 1456395771 Enrollment ID: I20050616000822 |
| Provider Name | Kathleen A Mcgarr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962432203 PECOS PAC ID: 0648215376 Enrollment ID: I20050623000278 |
| Provider Name | Peggy R Cyr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760584767 PECOS PAC ID: 0042255358 Enrollment ID: I20050627000640 |
| Provider Name | Paul B Murphy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871673574 PECOS PAC ID: 9133165327 Enrollment ID: I20050628000812 |
| Provider Name | Benedict J Farino |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104912864 PECOS PAC ID: 1850337619 Enrollment ID: I20050701000082 |
| Provider Name | Kristy A Murray-pulsifer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356310098 PECOS PAC ID: 5395781892 Enrollment ID: I20050706000997 |
| Provider Name | Victoria M Hayes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699894006 PECOS PAC ID: 5890721534 Enrollment ID: I20050713000813 |
| Provider Name | Stephen R Hayes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255369575 PECOS PAC ID: 9133156276 Enrollment ID: I20050720000972 |
| Provider Name | Thomas P Gearan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518073170 PECOS PAC ID: 8325012701 Enrollment ID: I20050729000509 |
| Provider Name | Eileen M Poulin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124146923 PECOS PAC ID: 7214967264 Enrollment ID: I20050818000840 |
| Provider Name | Rebecca B Hemphill |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245268903 PECOS PAC ID: 9032140140 Enrollment ID: I20050829000748 |
| Provider Name | Tevis H Gearan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205942877 PECOS PAC ID: 8224020441 Enrollment ID: I20050928001155 |
| Provider Name | Donald J Medd |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902810294 PECOS PAC ID: 3870528136 Enrollment ID: I20051005000806 |
| Provider Name | Edward M Tumavicus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316973969 PECOS PAC ID: 5698791325 Enrollment ID: I20051021000123 |
| Provider Name | Dale T Harrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467574772 PECOS PAC ID: 3971524448 Enrollment ID: I20051212000746 |
| Provider Name | David A Loxterkamp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982789087 PECOS PAC ID: 7810808821 Enrollment ID: I20051213000753 |
| Provider Name | Megan A Staton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235249137 PECOS PAC ID: 6002820941 Enrollment ID: I20060131000578 |
| Provider Name | Kristen B Silvia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538103478 PECOS PAC ID: 3779580139 Enrollment ID: I20061026000445 |
| Provider Name | Tara Kay Pelletier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124016118 PECOS PAC ID: 2264469089 Enrollment ID: I20061109000149 |
| Provider Name | Richard S Tockman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689631392 PECOS PAC ID: 3476555483 Enrollment ID: I20070205000189 |
| Provider Name | Joel Guarna |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376501833 PECOS PAC ID: 7113968074 Enrollment ID: I20070307000023 |
| Provider Name | Kimberly Comparetto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558440636 PECOS PAC ID: 9436254125 Enrollment ID: I20070425000465 |
| Provider Name | Brett Loffredo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295809911 PECOS PAC ID: 0547352866 Enrollment ID: I20070816000362 |
| Provider Name | William R Wadland |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1154499002 PECOS PAC ID: 0749372571 Enrollment ID: I20070823000753 |
| Provider Name | Peter G Amann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639107840 PECOS PAC ID: 5698848596 Enrollment ID: I20080725000427 |
| Provider Name | Theodore R Wissink |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124193503 PECOS PAC ID: 5890869770 Enrollment ID: I20080812000033 |
| Provider Name | Allyson S Howe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679662563 PECOS PAC ID: 3971662057 Enrollment ID: I20081104000417 |
| Provider Name | Joanna G Streeter |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1568658466 PECOS PAC ID: 1557421625 Enrollment ID: I20081119000233 |
| Provider Name | Elizabeth B Eisenhardt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194893982 PECOS PAC ID: 9830244672 Enrollment ID: I20090901000108 |
| Provider Name | Elizabeth H Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386750214 PECOS PAC ID: 9133165517 Enrollment ID: I20091110000305 |
| Provider Name | Joel L Botler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891764577 PECOS PAC ID: 1254470685 Enrollment ID: I20091125000074 |
| Provider Name | Jeffrey M Saffer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700824240 PECOS PAC ID: 8729079991 Enrollment ID: I20100216000610 |
| Provider Name | Timothy Gagne |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760681498 PECOS PAC ID: 5991820862 Enrollment ID: I20100915000743 |
| Provider Name | Jeffrey L Grassmann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750580486 PECOS PAC ID: 1850583873 Enrollment ID: I20101008000995 |
| Provider Name | Carly S Mcateer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699974311 PECOS PAC ID: 3971796228 Enrollment ID: I20101020000037 |
| Provider Name | Carol Kuhn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841375011 PECOS PAC ID: 0749479566 Enrollment ID: I20110110000888 |
| Provider Name | Donna C Kim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194897801 PECOS PAC ID: 1557541836 Enrollment ID: I20110203000194 |
| Provider Name | Eric S Haskell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770742439 PECOS PAC ID: 0648449769 Enrollment ID: I20110808000058 |
| Provider Name | Ellis A Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215196985 PECOS PAC ID: 7113196064 Enrollment ID: I20110809000905 |
| Provider Name | Elizabeth M Strawbridge |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548421878 PECOS PAC ID: 6507037850 Enrollment ID: I20110919000530 |
| Provider Name | Julia M Redding |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1932367034 PECOS PAC ID: 6406007293 Enrollment ID: I20121102000234 |
| Provider Name | Kristen A Scopaz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114171857 PECOS PAC ID: 6305097825 Enrollment ID: I20121109000505 |
| Provider Name | Amy M Roberts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225107519 PECOS PAC ID: 1052563897 Enrollment ID: I20121130000502 |
| Provider Name | Chelsea C Ginn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689923104 PECOS PAC ID: 8224280466 Enrollment ID: I20121214000193 |
| Provider Name | Amy E Vincent Cross |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497075592 PECOS PAC ID: 6406000587 Enrollment ID: I20130128000197 |
| Provider Name | Ann K Magner |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1205060225 PECOS PAC ID: 5395988505 Enrollment ID: I20130906000431 |
| Provider Name | Christine A Kleinman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043473457 PECOS PAC ID: 3779752829 Enrollment ID: I20130911000226 |
| Provider Name | Bradford S Wagner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083848030 PECOS PAC ID: 1456595313 Enrollment ID: I20130913000640 |
| Provider Name | Jennifer K Deane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265865323 PECOS PAC ID: 7517195852 Enrollment ID: I20140114000768 |
| Provider Name | John J Lowery |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770879520 PECOS PAC ID: 5698905032 Enrollment ID: I20140304000036 |
| Provider Name | Elizabeth R Bobzien |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144549320 PECOS PAC ID: 5890925101 Enrollment ID: I20140306002144 |
| Provider Name | Chloe G Farrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609298447 PECOS PAC ID: 2860615895 Enrollment ID: I20140520002677 |
| Provider Name | Samuel L Zager |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821383860 PECOS PAC ID: 1658505326 Enrollment ID: I20140818001769 |
| Provider Name | Katelyn Mp Lovely |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922383330 PECOS PAC ID: 0446405815 Enrollment ID: I20140818001851 |
| Provider Name | Krystian W Bigosinski |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1245450832 PECOS PAC ID: 3375680010 Enrollment ID: I20150303001291 |
| Provider Name | Heather M Gillespie |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1861561581 PECOS PAC ID: 1557457512 Enrollment ID: I20150309002313 |
| Provider Name | Lori Axelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578984142 PECOS PAC ID: 0042539090 Enrollment ID: I20150424001750 |
| Provider Name | Ingrid E Martin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952696973 PECOS PAC ID: 4981838653 Enrollment ID: I20150430000497 |
| Provider Name | Lisa Zummach |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598153348 PECOS PAC ID: 4183943327 Enrollment ID: I20150509000077 |
| Provider Name | Dayle R Dewey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669568184 PECOS PAC ID: 5597086637 Enrollment ID: I20150602000784 |
| Provider Name | Ellen H Theodores |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801197827 PECOS PAC ID: 5698096576 Enrollment ID: I20150603002417 |
| Provider Name | Nicole M Sawyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275931388 PECOS PAC ID: 3274846431 Enrollment ID: I20150716001644 |
| Provider Name | Alison N Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578825352 PECOS PAC ID: 7911131743 Enrollment ID: I20150729008024 |
| Provider Name | Kohar Dersimonian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538334594 PECOS PAC ID: 1951455625 Enrollment ID: I20150810002080 |
| Provider Name | Jonathan C Fellers |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1508091281 PECOS PAC ID: 6608021332 Enrollment ID: I20150831000427 |
| Provider Name | Robert A Fulton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023375953 PECOS PAC ID: 8820243322 Enrollment ID: I20150903000645 |
| Provider Name | Lindsey L Clement |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952754947 PECOS PAC ID: 9032406954 Enrollment ID: I20160921000296 |
| Provider Name | Adriana C Isacke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316208762 PECOS PAC ID: 2163656950 Enrollment ID: I20161005002585 |
| Provider Name | Scott P Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992048334 PECOS PAC ID: 9830326552 Enrollment ID: I20161026001932 |
| Provider Name | Brigitte Salembier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457797235 PECOS PAC ID: 0042452211 Enrollment ID: I20161102002011 |
| Provider Name | Nicole C. Guite |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1568758852 PECOS PAC ID: 2860661220 Enrollment ID: I20161115001275 |
| Provider Name | Kathleen E Brennan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922444900 PECOS PAC ID: 4284876590 Enrollment ID: I20161121001155 |
| Provider Name | Carol L Squires |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942546254 PECOS PAC ID: 9133401102 Enrollment ID: I20170127000141 |
| Provider Name | Elizabeth Kasny Sundborg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750835377 PECOS PAC ID: 0446548424 Enrollment ID: I20170405001582 |
| Provider Name | Sean T O'sullivan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285073205 PECOS PAC ID: 1153544374 Enrollment ID: I20170721001966 |
| Provider Name | Bryan A Lamoreau |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992117204 PECOS PAC ID: 4284850975 Enrollment ID: I20170912001081 |
| Provider Name | Elisabeth B Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417973587 PECOS PAC ID: 9032371208 Enrollment ID: I20170913002243 |
| Provider Name | Jillian J Dur |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1942647862 PECOS PAC ID: 6608091541 Enrollment ID: I20171003007639 |
| Provider Name | Margaret W Curran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891181285 PECOS PAC ID: 9032422613 Enrollment ID: I20180605001983 |
| Provider Name | Elizabeth V Seiverling |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1952438384 PECOS PAC ID: 4385778174 Enrollment ID: I20180723000879 |
| Provider Name | Adam C Normandin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588050850 PECOS PAC ID: 5496069551 Enrollment ID: I20180910002650 |
| Provider Name | Hadjh T Ahrns |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568606713 PECOS PAC ID: 3779726369 Enrollment ID: I20190314000956 |
| Provider Name | Gina N Dasilva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174039325 PECOS PAC ID: 5799026233 Enrollment ID: I20190409003088 |
| Provider Name | Devan Cole Lucier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811376072 PECOS PAC ID: 9032421953 Enrollment ID: I20191018002649 |
| Provider Name | Darlene E Peterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518353945 PECOS PAC ID: 4284948704 Enrollment ID: I20191021000709 |
| Provider Name | Marc D Kimball |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467815274 PECOS PAC ID: 6608162953 Enrollment ID: I20191108001186 |
Soul Sanctuary, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1519 Forest Ave, Portland, ME 04103 Phone: 617-690-9020 | |
Catholic Charities Maine Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 307 Congress Street, Portland, ME 04101 Phone: 207-781-8550 Fax: 207-781-8560 | |
Dani Fazio Psychotherapy Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 57 Exchange St Ste 203, Portland, ME 04101 Phone: 207-618-6588 Fax: 207-203-6480 | |
Ingraham Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 50 Monument Sq, Portland, ME 04101 Phone: 207-874-1055 Fax: 207-774-5901 | |
Alliance Residential Care, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 58 Boyd St Apt 501, Portland, ME 04101 Phone: 860-710-6770 | |
Scrx-lifetransitions Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 222 Saint John St Ste 208, Portland, ME 04102 Phone: 207-891-8618 | |
Lauren Grousd Lcpc Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 440 Forest Ave, Portland, ME 04101 Phone: 207-650-8906 Fax: 207-221-2130 |