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Organization

SEBASTICOOK VALLEY PRIMARY CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. GAETANE T BLAIR (BUSINESS MANAGER)
(207) 487-5071
Entity
Organization

Contact information

Practice address
140 CHANDLER STREET, PITTSFIELD, ME 04967-0515
(207) 487-9244
(207) 487-2834
Mailing address
PO BOX 515, 140 CHANDLER STREET, PITTSFIELD, ME 04967-0515
(207) 487-9244
(207) 487-2834

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
208000000X
Pediatrics Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
023158
DR. HUOT STAR ID
ME
01
024866
ANTHEM STAR ID
ME
Enumeration date
02/06/2007
Last updated
08/16/2007
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