Healthcare Provider Details

I. General information

NPI: 1609291020
Provider Name (Legal Business Name): SPECTRUM HEALTHCARE PARTNERS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2014
Last Update Date: 05/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

690 MINOT AVE SUITE 1
AUBURN ME
04210
US

IV. Provider business mailing address

324 GANNETT DR SUITE 200
SOUTH PORTLAND ME
04106-3270
US

V. Phone/Fax

Practice location:
  • Phone: 207-783-1315
  • Fax:
Mailing address:
  • Phone: 207-482-7800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number37757
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DAVID B. LANDRY
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 207-482-7800