Individual
DR. MARTHA M STAGAMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 MAIN ST, LEWISTON, ME 04240-7027
(207) 795-7575
(207) 795-7133
Mailing address
300 MAIN ST, LEWISTON, ME 04240-7027
(207) 795-7575
(207) 795-7133
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35-075318
OH
208M00000X
Hospitalist Physician
35-075318
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110230632
RR MEDICARE
OH
05
—
200377740
—
IN
05
—
2181017
—
OH
05
—
64080427
—
KY
Enumeration date
02/22/2006
Last updated
03/02/2017
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