Organization
MAINE MEDICAL PARTNERS
Active
Other names
Maine Medical Partners Pediatric Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN J KASABIAN (PRESIDENT)
(207) 661-2000
Entity
Organization
Contact information
Practice address
887 CONGRESS ST, SUITE 300, PORTLAND, ME 04102-3100
(207) 662-5555
(207) 662-5526
Mailing address
300 SOUTHBOROUGH DR, SUITE 201, SOUTH PORTLAND, ME 04106-6914
(207) 661-2000
(207) 661-2033
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
—
ME
2086S0120X
Pediatric Surgery Physician
Primary
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119910027
—
ME
05
—
30216371
—
NH
Enumeration date
01/18/2008
Last updated
12/13/2022
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