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Individual

SUSAN MIESFELDT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
100 CAMPUS DRIVE, SUITE 110, SCARBOROUGH, ME 04074
(207) 396-7678
(207) 396-8766
Mailing address
301C US ROUTE 1, SCARBOROUGH, ME 04074-9701
(207) 396-8600
(207) 396-8632

Taxonomy

Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
MD16381
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
022168
ANTHEM BCBS
ME
05
277890099
ME
01
30204925
NH MEDICAID
NH
01
3394475
AETNA HMO
ME
01
7338683
CIGNA
ME
01
7429082
AETNA
ME
01
P00142224
RAILROAD MEDICARE
ME
Enumeration date
01/30/2006
Last updated
11/26/2014
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