Healthcare Provider Details

I. General information

NPI: 1003098252
Provider Name (Legal Business Name): RHEUMATOLOGY ASSOCIATES P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2007
Last Update Date: 07/01/2024
Certification Date: 06/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 SEWALL ST
PORTLAND ME
04102-2643
US

IV. Provider business mailing address

51 SEWALL ST
PORTLAND ME
04102-2643
US

V. Phone/Fax

Practice location:
  • Phone: 207-370-3105
  • Fax: 207-874-7478
Mailing address:
  • Phone: 207-774-5761
  • Fax: 207-874-7478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: AMANDA NORSWORTHY
Title or Position: PRACTICE MANAGER
Credential:
Phone: 207-370-3105