Healthcare Provider Details

I. General information

NPI: 1790941805
Provider Name (Legal Business Name): FARIBA DAYHIM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2008
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 HIGH ST STE 2
LEWISTON ME
04240-7614
US

IV. Provider business mailing address

89 MAIN ST
ORONO ME
04473-4002
US

V. Phone/Fax

Practice location:
  • Phone: 207-344-2921
  • Fax:
Mailing address:
  • Phone: 207-356-1209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD18264
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number036.159773
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: