Healthcare Provider Details

I. General information

NPI: 1104403682
Provider Name (Legal Business Name): PATRICK JAMES TOLOSKY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 MAINE ST STE A200
BRUNSWICK ME
04011-3310
US

IV. Provider business mailing address

329 MAINE ST STE A200
BRUNSWICK ME
04011-3310
US

V. Phone/Fax

Practice location:
  • Phone: 207-373-4700
  • Fax: 207-618-5688
Mailing address:
  • Phone: 207-373-4700
  • Fax: 207-618-5688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD28535
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: