Organization
CENTRAL MAINE ORTHOPAEDICS AMBULATORY SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW DONALD BUSH MD (PHYSICIAN/PRESIDENT)
(207) 783-1328
Entity
Organization
Contact information
Practice address
690 MINOT AVE, SUITE ONE, AUBURN, ME 04210-3922
(207) 783-1315
(207) 786-3576
Mailing address
690 MINOT AVE, SUITE ONE, AUBURN, ME 04210-3922
(207) 783-1315
(207) 786-3576
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
36418
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116640200
MAINECARE
ME
01
—
MM0716
MEDICARE
—
Enumeration date
02/27/2007
Last updated
10/07/2011
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