Organization
MAINEHEALTH
Active
Other names
MMC PEDIATRIC INTENSIVE CARE UNIT
Organization subpart
No
Provider details
NPI number
Authorized official
LUGENE ANTHONY INZANA (ASSOCIATE CFO)
(207) 662-3538
Entity
Organization
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102
(207) 662-2179
(207) 662-6326
Mailing address
301 US ROUTE 1, BUILDING C, SCARBOROUGH, ME 04074-7609
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102500000
—
ME
Enumeration date
09/12/2006
Last updated
05/11/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us