Organization
MAINE MEDICAL PARTNERS
Active
Organization
MAINE MEDICAL PARTNERS
Active
Other names
Maine Medical Partners Neurology
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA JAUREGUI (DIR-PRVDR ENROLLMENT & CVO, MHMG PA)
(207) 661-5414
Entity
Organization
Contact information
Practice address
92 CAMPUS DRIVE, 2ND FLOOR, SCARBOROUGH, ME 04074
(207) 883-1414
(207) 883-1010
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
2084N0400X
Neurology Physician
Primary
—
—
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
—
—
2084N0600X
Clinical Neurophysiology Physician
—
—
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
—
—
2084V0102X
Vascular Neurology Physician
—
—
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
—
—
2471M1202X
Magnetic Resonance Imaging Radiologic Technologist
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30218004
—
NH
Enumeration date
02/10/2010
Last updated
12/13/2022
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