| Intermed, Pa | |
|
50 Foden Rd South Portland ME 04106-1718 | |
| (207) 523-3700 | |
| (207) 523-8591 |
| Full Name | Intermed, Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 50 Foden Rd, South Portland, Maine |
| Authorized Official Name and Position | William G Ferentz (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 2075233648 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Intermed, Pa 100 Gannett Dr Ste C South Portland ME 04106-5900 Ph: (207) 828-0361 | Intermed, Pa 50 Foden Rd South Portland ME 04106-1718 Ph: (207) 523-3700 |
| NPI Number | 1528535739 |
|---|---|
| Provider Enumeration Date | 10/25/2018 |
| Last Update Date | 07/15/2021 |
| Medicare PECOS PAC ID | 5092605261 |
|---|---|
| Medicare Enrollment ID | O20181121001531 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528535739 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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