MEDICARE: PATRICIA B STOGSDILL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD13332	ME
2	207RI0200X	Infectious Disease Physician	MD13332	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	014005	OTHER	ANTHEM
2	1040791	OTHER	AETNA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326009259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA B STOGSDILL MD

Provider Business Mailing Address
First Line	:	100 GANNETT DRIVE
Second Line	:	SUITE C
City	:	SOUTH PORTLAND
State	:	ME
Zip	:	04106
Country	:	US
Telephone Number	:	207-523-3649
Fax Number	:	207-874-1483

Provider Business Practice Location Address
First Line	:	50 FODEN RD, STE 3
Second Line	:
City	:	SOUTH PORTLAND
State	:	ME
Zip	:	04106-1718
Country	:	US
Telephone Number	:	207-774-5816
Fax Number	:	207-523-8594

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2006
Last Update Date	:	01/31/2019

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Directions to “ PATRICIA B STOGSDILL MD” Practice Location

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