Healthcare Provider Details

I. General information

NPI: 1306045521
Provider Name (Legal Business Name): MARGARET A BORDEAU D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 11/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER DR
BIDDEFORD ME
04005-9422
US

IV. Provider business mailing address

9 HEALTHCARE DR SUITE 208
BIDDEFORD ME
04005-9449
US

V. Phone/Fax

Practice location:
  • Phone: 207-283-7000
  • Fax: 207-286-3787
Mailing address:
  • Phone: 207-282-9080
  • Fax: 207-286-3787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2131
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: