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Organization

MAINE MEDICAL PARTNERS

Active
Other names
Maine Medical Partners Pediatric Specialty Care
Organization subpart
No

Provider details

NPI number
Authorized official
STEPHEN J KASABIAN (PRESIDENT)
(207) 661-2000
Entity
Organization

Contact information

Practice address
887 CONGRESS ST, SUITE 320, PORTLAND, ME 04102-3100
(207) 662-5522
Mailing address
300 SOUTHBOROUGH DR, SUITE 201, SOUTH PORTLAND, ME 04106-6914
(207) 661-2000
(207) 661-2033

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
1041C0700X
Clinical Social Worker
133V00000X
Registered Dietitian
170300000X
Genetic Counselor (M.S.)
ME
2080P0006X
Developmental - Behavioral Pediatrics Physician
2080P0205X
Pediatric Endocrinology Physician
2080P0206X
Pediatric Gastroenterology Physician
Primary
2080P0208X
Pediatric Infectious Diseases Physician
2080P0210X
Pediatric Nephrology Physician
2080P0214X
Pediatric Pulmonology Physician
363LF0000X
Family Nurse Practitioner
363LP0200X
Pediatric Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
119910001
ME
05
119910018
ME
05
119910019
ME
05
119910027
ME
05
119910028
ME
05
30006478
NH
05
30216371
NH
Enumeration date
07/29/2006
Last updated
12/13/2022
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