Individual
DR. ALEXANDRA MARIA ELIZABETH IDENBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, MRCGP(UK)
Contact information
Practice address
105 MAIN ST, PITTSFIELD, ME 04967-4364
(207) 487-7292
(207) 487-7156
Mailing address
105 MAIN ST, PITTSFIELD, ME 04967-4364
(207) 487-7292
(207) 487-7156
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD19326
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558862508
HEALTH PLANS INC
ME
05
—
1558862508
—
ME
01
—
1992133102
HARVARD PILGRIM
ME
05
—
1992133102
—
ME
Enumeration date
10/25/2013
Last updated
11/27/2024
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