Organization
INTERMED, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER POITRAS (CHIEF EXECUTIVE OFFICER)
(207) 347-2947
Entity
Organization
Contact information
Practice address
100 FODEN, WEST, SOUTH PORTLAND, ME 04106
(207) 523-3767
Mailing address
100 GANNETT DR STE C, SOUTH PORTLAND, ME 04106-5900
(207) 347-2947
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
231H00000X
Audiologist
—
—
Other
Enumeration date
09/23/2025
Last updated
09/23/2025
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