Healthcare Provider Details

I. General information

NPI: 1932154895
Provider Name (Legal Business Name): ANNE L VISELLI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 FRANKLIN HEALTH CMNS
FARMINGTON ME
04938-6144
US

IV. Provider business mailing address

181 FRANKLIN HEALTH CMNS
FARMINGTON ME
04938-6144
US

V. Phone/Fax

Practice location:
  • Phone: 207-778-6394
  • Fax: 207-778-2886
Mailing address:
  • Phone: 207-778-6394
  • Fax: 207-778-2886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberMD29234
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number0420008739
License Number StateVT
# 3
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number0420008739
License Number StateVT
# 4
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD29234
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: