# MAINE MEDICAL PARTNERS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Maine Medical Partners Cardiovascular Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174897078
- **Authorized official:** DONNA JAUREGUI (DIRECTOR PROVIDER ENROLLMENT & CVO)
- **Authorized official phone:** (207) 661-5414

## Contact information

- **Practice address:** 818 CONGRESS ST, PORTLAND, ME 04102-3112
- **Practice address phone:** (207) 773-8161
- **Practice address fax:** (207) 773-1489
- **Mailing address:** 190 RIVERSIDE STREET, PORTLAND, ME 04103
- **Mailing address phone:** (207) 661-2095
- **Mailing address fax:** (207) 661-2033

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |
| 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