Organization
RICHARD J MAZZEI MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD J MAZZEI MD (MD OWNER)
(207) 947-2788
Entity
Organization
Contact information
Practice address
77 BROADWAY, BANGOR, ME 04401
(207) 947-2788
(207) 990-2545
Mailing address
77 BROADWAY, BANGOR, ME 04401
(207) 947-2788
(207) 990-2545
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
010002
ME
363LF0000X
Family Nurse Practitioner
F0607063
ME
363LF0000X
Family Nurse Practitioner
R030879
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002154
ANTHEM
—
01
—
100423
ANTHEM
ME
Enumeration date
02/28/2008
Last updated
02/28/2008
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