Healthcare Provider Details

I. General information

NPI: 1326570078
Provider Name (Legal Business Name): RYAN T DONOHUE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2017
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 MILES CENTER WAY
DAMARISCOTTA ME
04543-4067
US

IV. Provider business mailing address

24 MILES CENTER WAY
DAMARISCOTTA ME
04543-4067
US

V. Phone/Fax

Practice location:
  • Phone: 207-563-4250
  • Fax: 207-810-4977
Mailing address:
  • Phone: 207-563-4250
  • Fax: 207-810-4977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD23749
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: