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Organization
MAINE MEDICAL PARTNERS
Active
Organization
MAINE MEDICAL PARTNERS
Active
Other names
Maine Medical Partners Cardiovascular Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA JAUREGUI (DIRECTOR PROVIDER ENROLLMENT & CVO)
(207) 661-5414
Entity
Organization
Contact information
Practice address
818 CONGRESS ST, PORTLAND, ME 04102-3112
(207) 773-8161
(207) 773-1489
Mailing address
190 RIVERSIDE STREET, PORTLAND, ME 04103
(207) 661-2095
(207) 661-2033
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
NULL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
363AS0400X
Surgical Physician Assistant
—
NULL
363AS0400X
Surgical Physician Assistant
—
—
363LA2100X
Acute Care Nurse Practitioner
—
NULL
363LA2100X
Acute Care Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
NULL
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Enumeration date
02/24/2012
Last updated
12/13/2022
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