Healthcare Provider Details

I. General information

NPI: 1083636039
Provider Name (Legal Business Name): MIDCOAST HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 06/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1356A WASHINGTON ST
BATH ME
04530-2847
US

IV. Provider business mailing address

1356A WASHINGTON ST
BATH ME
04530-2847
US

V. Phone/Fax

Practice location:
  • Phone: 207-443-6702
  • Fax: 207-443-2317
Mailing address:
  • Phone: 207-443-6702
  • Fax: 207-443-2317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: GEORGE HUNTER
Title or Position: VICE PRESIDENT
Credential:
Phone: 207-373-6027