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Individual

DR. STEPHEN M JENDZEJEC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
127 LONG SANDS RD, SUITE 11, YORK, ME 03909-1158
(207) 363-8430
(207) 351-3006
Mailing address
127 LONG SANDS RD, SUITE 11, YORK, ME 03909-1158
(207) 363-8430
(207) 351-3006

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1287
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
003689
ANTHEM BLUE CROSS BLUE SH
01
010467585
AETNA HMO
01
010467585001
ANTHEM BLUE CROSS BLUE SH
01
0405236YPME01
ANTHEM BCBS NEW HAMPSHIRE
01
080140515
RAILROAD MEDICARE
01
283840099
PRIMECARE MEDICAID
05
283840099
ME
01
3646359
CIGNA HEALTHCARE
01
596163
AETNA NONHMO GROUP
01
E10019
HARVARD PILGRIM
01
MM2427
MEDICARE B
01
YORK083565
ANTHEM BCBS NEW HAMPSHIRE
Enumeration date
04/07/2006
Last updated
04/12/2011
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