Healthcare Provider Details

I. General information

NPI: 1902483340
Provider Name (Legal Business Name): CAITLYN DESIR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 MEDICAL CENTER DR STE 2350
BRUNSWICK ME
04011-2780
US

IV. Provider business mailing address

81 MEDICAL CENTER DR STE 2350
BRUNSWICK ME
04011-2780
US

V. Phone/Fax

Practice location:
  • Phone: 207-373-6690
  • Fax: 207-956-5194
Mailing address:
  • Phone: 207-373-6690
  • Fax: 207-956-5194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberMD30528
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: