MEDICARE: MATS AGREN M.D.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	013728	ME
2	207X00000X	Orthopaedic Surgery Physician	MD13728	ME

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	200032053	OTHER	ME	RAILROAD MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1041014	OTHER	ME	AETNA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	034482	OTHER	ME	ANTHEM
4	1120990001	OTHER	ME	DMERC
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	F56356	OTHER	ME	HARVARD PILGRIM HC
8	M84374	OTHER	ME	CIGNA HEALTHSOURCE

NPI Number	:	1427003417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATS AGREN M.D.

Provider Business Mailing Address
First Line	:	20 NORTHBROOK DR
Second Line	:
City	:	FALMOUTH
State	:	ME
Zip	:	04105-1318
Country	:	US
Telephone Number	:	207-781-4424
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 NORTHBROOK DR
Second Line	:
City	:	FALMOUTH
State	:	ME
Zip	:	04105-1318
Country	:	US
Telephone Number	:	207-781-4424
Fax Number	:

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	06/14/2019

22 NORTHBROOK DR
FALMOUTH, ME
04105-1318

Practice Phone: 323-928-9445
Practice Fax: