Individual
EMIL PETER MISKOVSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
93 CAMPUS AVE, LEWISTON, ME 04240-6030
(207) 755-3636
(207) 755-3652
Mailing address
C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT, PO BOX 7291, LEWISTON, ME 04243
(207) 777-8950
(207) 777-8800
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
0420010255
VT
207RG0100X
Gastroenterology Physician
291445
NY
207RG0100X
Gastroenterology Physician
Primary
MD19652
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007971
—
VT
01
—
105305
MVP
VT
01
—
58290
BLUE CROSS AND BLUE SHIEL
VT
Enumeration date
09/12/2005
Last updated
01/23/2024
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