Individual
MARK T. MAINELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
24 MILES CENTER WAY, DAMARISCOTTA, ME 04543-4047
(207) 563-4252
(207) 563-4275
Mailing address
24 MILES CENTER WAY, DAMARISCOTTA, ME 04543-4047
(207) 563-4252
(207) 563-4275
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
1799
ME
208600000X
Surgery Physician
Primary
DO1799
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
283930099
—
ME
Enumeration date
07/07/2005
Last updated
10/09/2018
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