Organization
MAINEHEALTH
Active
Parent organization
MAINEHEALTH
Other names
MMC CF Clinic
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
22 BRAMHALL ST, PORTLAND, ME 04102
(207) 662-0111
Mailing address
301C US ROUTE 1, SCARBOROUGH, ME 04074-9701
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30212545
—
NH
Enumeration date
05/22/2012
Last updated
05/11/2020
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