Individual
DR. MICHAEL A DEDEKIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
887 CONGRESS ST, SUITE 320, PORTLAND, ME 04102
(207) 662-5522
(207) 662-5527
Mailing address
301 US ROUTE 1, BUILDING C, SCARBOROUGH, ME 04074-7609
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
224852
MA
2080P0205X
Pediatric Endocrinology Physician
Primary
017981
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2110318
—
MA
05
—
30208479
—
NH
05
—
433775099
—
ME
Enumeration date
02/27/2006
Last updated
01/04/2011
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