Organization
INTERMED, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER A. POITRAS (CHIEF EXECUTIVE OFFICER)
(207) 347-2853
Entity
Organization
Contact information
Practice address
100 GANNETT DR, SUITE C, SOUTH PORTLAND, ME 04106-5900
(207) 828-0361
(207) 874-1483
Mailing address
100 GANNETT DR STE C, SOUTH PORTLAND, ME 04106-5900
(207) 347-2947
(855) 576-4814
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208000000X
Pediatrics Physician
—
—
2084N0400X
Neurology Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208D00000X
General Practice Physician
—
—
225100000X
Physical Therapist
—
—
Other
Enumeration date
01/26/2006
Last updated
05/12/2026
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