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Organization

WEBBER HOSPITAL ASSOCIATION

Active
Other names
SMMC Coastal Surgical Associates
Organization subpart
No

Provider details

NPI number
Authorized official
FRANK W LAVOIE MD (VP MEDICAL AFFAIRS)
(207) 283-7000
Entity
Organization

Contact information

Practice address
3 MEDICAL CENTER DR, BIDDEFORD, ME 04005-9422
(207) 284-4597
(207) 282-9213
Mailing address
39 WALLACE AVE, SOUTH PORTLAND, ME 04106-6143
(207) 761-0650
(207) 761-0650

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2086S0129X
Vascular Surgery Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101580000
ME
05
30216515
NH
05
432732805
ME
Enumeration date
04/10/2008
Last updated
06/09/2008
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