Healthcare Provider Details

I. General information

NPI: 1659364420
Provider Name (Legal Business Name): SARAH D MUSCAT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2005
Last Update Date: 09/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 STATE ST MERCY PAIN CENTER
PORTLAND ME
04101-3776
US

IV. Provider business mailing address

144 STATE ST MERCY PAIN CENTER
PORTLAND ME
04101-3776
US

V. Phone/Fax

Practice location:
  • Phone: 207-535-1800
  • Fax: 207-535-1818
Mailing address:
  • Phone: 207-535-1800
  • Fax: 207-535-1818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number015430
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number015430
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number015430
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: