Organization
FREEPORT CARDIOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN M CORBETT (BILLING REPRESENTATIVE)
(207) 497-2996
Entity
Organization
Contact information
Practice address
100 SPENCER'S RIDGE RD., FREEPORT, ME 04032-7138
(207) 865-7088
Mailing address
17 BETTYS LN, HARWICH, MA 02645-2517
(207) 497-2996
(877) 203-7619
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
017412
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679708168
BCBS
ME
Enumeration date
05/27/2009
Last updated
11/19/2011
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