Organization
VALLEY MEDICAL ASSOCIATION
Active
Other names
Long Lake Regional Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER SIROIS (CEO)
(207) 834-1408
Entity
Organization
Contact information
Practice address
384 MAIN ST, ST AGATHA, ME 04772
(207) 543-7567
Mailing address
194 E MAIN ST, FORT KENT, ME 04743
(207) 834-5877
(207) 834-2522
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165800103
—
ME
Enumeration date
01/17/2006
Last updated
05/17/2011
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