Organization
THE MAINE SURGICAL CARE GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENS ELDRUP-JORGENSEN MD (PRESIDENT)
(207) 774-6368
Entity
Organization
Contact information
Practice address
887 CONGRESS ST, SUITE 400, PORTLAND, ME 04102-3100
(207) 774-6368
(207) 774-9388
Mailing address
887 CONGRESS ST, SUITE 400, PORTLAND, ME 04102-3100
(207) 774-6368
(207) 774-9388
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
—
2086X0206X
Surgical Oncology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C12425
RAILROAD MEDICARE
ME
Enumeration date
12/22/2005
Last updated
03/04/2008
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