Organization
MAINEHEALTH
Active
Parent organization
MAINEHEALTH
Other names
Maine Medical Partners Otolaryngology
Organization subpart
Yes
Provider details
NPI number
Legal business name
MAINEHEALTH
Authorized official
LUGENE ANTHONY INZANA (ASSOCIATE CFO)
(207) 662-3538
Entity
Organization
Contact information
Practice address
1250 FOREST AVE, PORTLAND, ME 04103
(207) 797-5753
(207) 797-9571
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-6562
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
231H00000X
Audiologist
—
—
282N00000X
General Acute Care Hospital
37563
ME
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
02/25/2011
Last updated
12/19/2022
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