Organization
MID MAINE GASTROENTEROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA RAYE BAKER (OFFICE MANAGER)
(207) 872-2424
Entity
Organization
Contact information
Practice address
325E KENNEDY MEMORIAL DR, WATERVILLE, ME 04901-4531
(207) 872-2424
(207) 872-2099
Mailing address
325E KENNEDY MEMORIAL DR, WATERVILLE, ME 04901-4531
(207) 872-2424
(207) 872-2099
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G0078
ANTHEM
ME
Enumeration date
06/05/2007
Last updated
10/25/2007
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