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Individual

MICHAEL ALEXANDER FERGUSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
22 BRAMHALL ST, MMC PICU, PORTLAND, ME 04102-3134
(207) 662-6711
Mailing address
190 RIVERSIDE ST, SUITE 6B, PORTLAND, ME 04103-1073
(207) 661-2000

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
247146
MA
208000000X
Pediatrics Physician
Primary
MD20538
ME
2080P0203X
Pediatric Critical Care Medicine Physician
247146
MA
2080P0203X
Pediatric Critical Care Medicine Physician
MT202833
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1013181668
ME
Enumeration date
04/15/2008
Last updated
10/16/2024
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