Individual
MATTHEW FASOLINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
272 CONGRESS ST, PORTLAND, ME 04101-3637
(207) 662-5856
Mailing address
272 CONGRESS ST, PORTLAND, ME 04101-3637
(207) 662-5856
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO2951
ME
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/29/2017
Last updated
07/31/2025
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