Organization
MAINEHEALTH
Active
Parent organization
MAINE MEDICAL CENTER
Other names
Maine Medical Partners Urology
Organization subpart
Yes
Provider details
NPI number
Legal business name
MAINE MEDICAL CENTER
Authorized official
LUGENE ANTHONY INZANA (ASSOCIATE CFO)
(207) 662-3538
Entity
Organization
Contact information
Practice address
100 BRICKHILL AVE, SOUTH PORTLAND, ME 04106
(207) 773-1728
(207) 772-4062
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-6562
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
282N00000X
General Acute Care Hospital
37563
ME
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
10/15/2010
Last updated
12/19/2022
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