Healthcare Provider Details

I. General information

NPI: 1033185988
Provider Name (Legal Business Name): STEPHANIE G BARTHOLOMEW MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE CALKINS MD

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 05/26/2022
Certification Date: 05/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 SHERIDAN RD
FAIRFIELD ME
04937-3314
US

IV. Provider business mailing address

4 SHERIDAN RD
FAIRFIELD ME
04937-3314
US

V. Phone/Fax

Practice location:
  • Phone: 207-861-5559
  • Fax: 207-861-5082
Mailing address:
  • Phone: 207-861-5559
  • Fax: 207-861-5082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number015469
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: