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Organization
MAINE CENTERS FOR HEALTHCARE PA
Active
Organization
MAINE CENTERS FOR HEALTHCARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OWEN B PICKUS D.O. (MEDICAL DIRECTOR)
(207) 857-9311
Entity
Organization
Contact information
Practice address
2 CHABOT ST, WESTBROOK, ME 04092-4817
(207) 857-9311
(207) 857-9324
Mailing address
2 CHABOT ST, WESTBROOK, ME 04092-4817
(207) 857-9311
(207) 857-9324
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
2084N0400X
Neurology Physician
—
—
208600000X
Surgery Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110890000
—
ME
Enumeration date
05/31/2006
Last updated
09/09/2013
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