Healthcare Provider Details

I. General information

NPI: 1902021447
Provider Name (Legal Business Name): WESTERN MAINE MULTI MEDICAL SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

193 MAIN ST SUITE 9
NORWAY ME
04268-5645
US

IV. Provider business mailing address

PO BOX 360279
PITTSBURGH PA
15251-6279
US

V. Phone/Fax

Practice location:
  • Phone: 207-743-8766
  • Fax: 207-743-1579
Mailing address:
  • Phone: 207-396-8600
  • Fax: 207-396-8632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: LUGENE A INZANA
Title or Position: ASSOCIATE CFO
Credential:
Phone: 207-661-1346