Healthcare Provider Details

I. General information

NPI: 1063502995
Provider Name (Legal Business Name): CHRISTOPHER A REGNIER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 STATION AVE STE 201
BRUNSWICK ME
04011-2092
US

IV. Provider business mailing address

33 SEWALL ST
PORTLAND ME
04102-2603
US

V. Phone/Fax

Practice location:
  • Phone: 207-482-7800
  • Fax:
Mailing address:
  • Phone: 207-828-2101
  • Fax: 207-553-7166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberDO2930
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: