Healthcare Provider Details

I. General information

NPI: 1164561478
Provider Name (Legal Business Name): WESTERN MAINE MULTI-MEDICAL SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 S RIDGE RD
NEWRY ME
04261-3229
US

IV. Provider business mailing address

181 MAIN ST
NORWAY ME
04268-5664
US

V. Phone/Fax

Practice location:
  • Phone: 207-824-4900
  • Fax: 207-824-4910
Mailing address:
  • Phone: 207-743-1562
  • Fax: 207-743-1566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN W COX
Title or Position: SENIOR VICE PRESIDENT FISCAL
Credential:
Phone: 207-743-5933