Healthcare Provider Details

I. General information

NPI: 1649218660
Provider Name (Legal Business Name): RENEE M FAY-LEBLANC MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 GLEN COVE DR
ROCKPORT ME
04856-4272
US

IV. Provider business mailing address

6 GLEN COVE DR
ROCKPORT ME
04856-4272
US

V. Phone/Fax

Practice location:
  • Phone: 207-301-8542
  • Fax: 207-301-5277
Mailing address:
  • Phone: 207-301-8542
  • Fax: 207-301-5277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD17048
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD17048
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: