| Maine Street Medical Pllc | |
|
8 Mason St Brunswick ME 04011-1514 | |
| (314) 249-9759 | |
| Not Available |
| Full Name | Maine Street Medical Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 8 Mason St, Brunswick, Maine |
| Authorized Official Name and Position | Andreas Thyssen (CO-OWNER) |
| Authorized Official Contact | 3142499759 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maine Street Medical Pllc 22 Dionne Cir Brunswick ME 04011-3211 Ph: (314) 249-9759 | Maine Street Medical Pllc 8 Mason St Brunswick ME 04011-1514 Ph: (314) 249-9759 |
| NPI Number | 1598477887 |
|---|---|
| Provider Enumeration Date | 12/19/2022 |
| Last Update Date | 06/08/2023 |
| Medicare PECOS PAC ID | 3375917321 |
|---|---|
| Medicare Enrollment ID | O20230315000734 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598477887 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| Provider Name | Kathryn M Brouillette |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881980332 PECOS PAC ID: 0143456244 Enrollment ID: I20151203002044 |
| Provider Name | Allison L. Buttarazzi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871939884 PECOS PAC ID: 4688816986 Enrollment ID: I20160919001584 |
| Provider Name | Andreas Pm Thyssen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215373279 PECOS PAC ID: 7113169376 Enrollment ID: I20170829000592 |
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