Organization
MAINEHEALTH
Active
Parent organization
MAINEHEALTH
Other names
MMP Orthopedics ( Div of Orthopedic Trauma & Fracture Care)
Organization subpart
Yes
Provider details
NPI number
Legal business name
MAINEHEALTH
Authorized official
LUGENE ANTHONY INZANA (ASSOCIATE CFO)
(207) 662-3538
Entity
Organization
Contact information
Practice address
335 BRIGHTON AVE, SUITE 200, PORTLAND, ME 04102-2363
(207) 662-8600
(207) 662-8668
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-6562
Taxonomy
Speciality
Code
Description
License number
State
207XX0801X
Orthopaedic Trauma Physician
Primary
—
—
282N00000X
General Acute Care Hospital
37563
ME
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
02/25/2011
Last updated
05/11/2020
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