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Organization

MAINEHEALTH

Active
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Organization

MAINEHEALTH

Active
Parent organization
MAINEHEALTH
Other names
MaineHealth Medical Group-Primary Care
Organization subpart
Yes

Provider details

NPI number
Legal business name
MAINEHEALTH
Authorized official
MR. LUGENE A INZANA (ASSOCIATE CFO)
(207) 661-1346
Entity
Organization

Contact information

Practice address
110 FREE ST, PORTLAND, ME 04101-3908
(207) 661-7001
Mailing address
PO BOX 360489, PITTSBURGH, PA 15251-6489
(207) 887-5100

Taxonomy

Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
207Q00000X
Family Medicine Physician
207QG0300X
Geriatric Medicine (Family Medicine) Physician
207R00000X
Internal Medicine Physician
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
208000000X
Pediatrics Physician
261Q00000X
Clinic/Center
Primary

Other

Enumeration date
05/24/2023
Last updated
05/15/2025
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