Healthcare Provider Details

I. General information

NPI: 1215981790
Provider Name (Legal Business Name): DOWNEAST MEDICAL ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 12/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 MAIN ST SUITE 1
MACHIAS ME
04654-3606
US

IV. Provider business mailing address

PO BOX 317
MACHIAS ME
04654-0317
US

V. Phone/Fax

Practice location:
  • Phone: 207-255-6831
  • Fax: 207-255-6832
Mailing address:
  • Phone: 207-255-6831
  • Fax: 207-255-6832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: AZIZ A. MASSAAD
Title or Position: PRESIDENT
Credential: M.D.
Phone: 207-255-6831