Healthcare Provider Details

I. General information

NPI: 1720908254
Provider Name (Legal Business Name): MD3 OF MAINE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CONY RD STE C
AUGUSTA ME
04330-0506
US

IV. Provider business mailing address

10 CONY RD STE C
AUGUSTA ME
04330-0506
US

V. Phone/Fax

Practice location:
  • Phone: 207-485-2666
  • Fax:
Mailing address:
  • Phone: 207-485-2666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JONNATHAN BUSKO
Title or Position: ASSISTANT DIRECTOR
Credential: MD
Phone: 207-485-2666