Individual
MICHAEL MARCHETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MT
Contact information
Practice address
222 SAINT JOHN ST, SUITE 214, PORTLAND, ME 04102-3000
(207) 871-7657
Mailing address
222 SAINT JOHN ST, SUITE 214, PORTLAND, ME 04102-3000
(207) 871-7657
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MT1203
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
048209
BLUE CROSS BLUE SHIELD
ME
Enumeration date
06/26/2006
Last updated
07/08/2007
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