Healthcare Provider Details

I. General information

NPI: 1689779092
Provider Name (Legal Business Name): STEPHEN ROSS BARTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 06/02/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 MESERVE STREET NAPLES PROFESSIONAL CENTER
NAPLES ME
04055-5349
US

IV. Provider business mailing address

PO BOX 1515 4 MESERVE ST
NAPLES ME
04055
US

V. Phone/Fax

Practice location:
  • Phone: 207-693-3912
  • Fax: 207-693-3453
Mailing address:
  • Phone: 207-693-3912
  • Fax: 207-693-3453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number11337
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: