Healthcare Provider Details

I. General information

NPI: 1952403560
Provider Name (Legal Business Name): STEVEN MARTEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2006
Last Update Date: 07/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 MAIN ST
LEWISTON ME
04240-7027
US

IV. Provider business mailing address

29 LOWELL ST
LEWISTON ME
04240-7639
US

V. Phone/Fax

Practice location:
  • Phone: 207-795-0111
  • Fax: 207-795-2766
Mailing address:
  • Phone: 207-755-3864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD20995
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: