Organization
CARDIOVASCULAR CONSULTANTS OF MAINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM A DIETZ M.D. (PRESIDENT)
(207) 885-9905
Entity
Organization
Contact information
Practice address
96 CAMPUS DR STE 1, SCARBOROUGH, ME 04074-7133
(207) 885-9905
Mailing address
96 CAMPUS DR STE 1, SCARBOROUGH, ME 04074-7133
(207) 885-9905
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
ME
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
ME
207RI0011X
Interventional Cardiology Physician
—
ME
207UN0901X
Nuclear Cardiology Physician
—
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109260000
—
ME
Enumeration date
07/04/2006
Last updated
09/23/2009
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