Organization
MAINE MEDICAL PARTNERS
Active
Other names
Maine Medical Partners Neurosurgery & Spine
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA JAUREGUI (DIR-PRVDR ENROLLMENT & CVO, MHMG PA)
(207) 661-5414
Entity
Organization
Contact information
Practice address
92 CAMPUS DRIVE, 1ST FLOOR, SCARBOROUGH, ME 04074
(207) 885-0011
(207) 883-2586
Mailing address
300 SOUTHBOROUGH DR, SUITE 201, SOUTH PORTLAND, ME 04106-6914
(207) 661-2000
(207) 661-2033
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
—
—
207T00000X
Neurological Surgery Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
225100000X
Physical Therapist
—
—
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130950000
—
ME
05
—
30215114
—
NH
Enumeration date
01/19/2006
Last updated
08/25/2022
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