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NPI Code Detail

MEDICARE: DR. PATRICK J. FALLON M.D.

MEDICARE:  DR. PATRICK J. FALLON  M.D.
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
1207X00000XOrthopaedic Surgery Physician013805ME

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
6200044523OTHERRR MEDICARE
7201017OTHERMEDICARE ASC FACILITY
8MM0716OTHERMEDICARE CLINIC FACILITY
10MM583301OTHERNEW MEDICARE PTAN
13MM5833OTHERMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10378600001OTHERDMERC
2100294000OTHERUSPS WC
31044480OTHERAETNA
4010416156OTHERTRAVELERS/CORE/MEDNET
5314430099OTHERMEMAINECARE
9043465OTHERANTHEM
114229509OTHERCIGNA
12173418OTHERHARVARD

General Provider Information

NPI Number : 1396740544
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PATRICK J. FALLON M.D.
Provider Business Mailing Address
First Line : 690 MINOT AVE
Second Line : STE 1
City : AUBURN
State : ME
Zip : 04210-3922
Country : US
Telephone Number : 207-783-1328
Fax Number : 207-795-0260
Provider Business Practice Location Address
First Line : 690 MINOT AVE
Second Line : STE 1
City : AUBURN
State : ME
Zip : 04210-3922
Country : US
Telephone Number : 207-783-1328
Fax Number : 207-795-0260
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2005
Last Update Date : 10/07/2011

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1477558278 — DR. DAVID G. BROWN M.D.
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1063412211 — DR. MATTHEW MURRAY MCLAUGHLIN MD
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Directions to “ DR. PATRICK J. FALLON M.D.” Practice Location

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