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Organization
INTERMED, PA
Active
Organization
INTERMED, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER A. POITRAS (CHIEF EXECUTIVE OFFICER)
(207) 347-2853
Entity
Organization
Contact information
Practice address
50 FODEN RD, SOUTH PORTLAND, ME 04106-1718
(207) 523-3700
(855) 576-4814
Mailing address
100 GANNETT DR STE C, SOUTH PORTLAND, ME 04106-5900
(207) 347-2947
(204) 874-2317
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
2084N0400X
Neurology Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
225100000X
Physical Therapist
—
—
Other
Enumeration date
10/25/2018
Last updated
05/12/2026
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