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Individual

KEASHA DANIELLE MARESCOT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
43 SOKOKIS TRAIL, E WATERBORO, ME 04030
(207) 247-6742
(207) 247-6114
Mailing address
PO BOX 1849, LEWISTON, ME 04241-1849
(207) 784-2554
(207) 777-5363

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
015675
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0055B749
CHAMPUS
01
046260
ANTHEM
01
046261
BLUE SHIELD
ME
01
050562391
COMMERCIAL
05
281130099
ME
05
30205519
NH
01
3179929
AETNA
01
M555815
CIGNA
NH
Enumeration date
01/25/2006
Last updated
05/07/2008
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