Organization
DOWN EAST ORTHOPEDIC ASSOC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD MERRILL (ADMINISTRATOR)
(207) 307-8954
Entity
Organization
Contact information
Practice address
78 RIDGEWOOD DR, BANGOR, ME 04401-2652
(207) 947-8381
(207) 942-5631
Mailing address
78 RIDGEWOOD DR, BANGOR, ME 04401-2652
(207) 947-8381
(207) 947-1897
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
ME
225100000X
Physical Therapist
—
ME
225X00000X
Occupational Therapist
—
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105820000
—
ME
01
—
CF4751
RAIL ROAD MEDICARE GROUP
ME
Enumeration date
06/03/2006
Last updated
07/16/2021
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