MEDICARE: MR. STEVE BIJOGA

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1861030553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEVE BIJOGA

Provider Business Mailing Address
First Line	:	1350 FOREST AVE APT 16
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04103-1815
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1350 FOREST AVE APT 16
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04103-1815
Country	:	US
Telephone Number	:	207-518-1901
Fax Number	:

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

Provider Enumeration Date	:	12/13/2019
Last Update Date	:	12/13/2019

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Directions to “ MR. STEVE BIJOGA ” Practice Location

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