Individual
DR. MARK D COUSINEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-7050
(207) 662-7054
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-7050
(207) 662-7054
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
59926
KY
207P00000X
Emergency Medicine Physician
Primary
EC-05-081
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490446404A
—
GA
Enumeration date
10/18/2006
Last updated
03/09/2026
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