Individual
DR. THADDEUS T SHATTUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
330 SABATTUS ST STE A, LEWISTON, ME 04240-5553
(207) 777-8959
(207) 753-3093
Mailing address
165 LANCASTER ST, PORTLAND, ME 04101-2406
(207) 874-1030
(207) 874-1044
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
018527
ME
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
MD18527
ME
Other
Enumeration date
12/21/2006
Last updated
03/27/2024
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