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Organization

FOOT AND ANKLE SURGICAL ASSOC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STEVEN BRAGG (BILLING MANAGER)
(207) 854-1544
Entity
Organization

Contact information

Practice address
952 POST ROAD, FOOT AND ANKLE SURGICAL ASSOC, WELLS, ME 04090
(207) 646-9996
(207) 646-9949
Mailing address
PO BOX 810, FOOT AND ANKLE SURGICAL ASSOC, WESTBROOK, ME 04098-0810
(207) 854-1544
(207) 854-1516

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
POD1039
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
022848
ANTHEM MAINE
ME
01
1205816766
GROUP NPI #
ME
01
1659479541
IND NPI #
ME
05
431952200
ME
01
MM9150
MEDICARE IND PIN
ME
Enumeration date
01/20/2006
Last updated
07/22/2008
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