Healthcare Provider Details

I. General information

NPI: 1831187707
Provider Name (Legal Business Name): AMIT SANYAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2005
Last Update Date: 02/02/2026
Certification Date: 02/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 INDUSTRIAL AVE STE 101
SANFORD ME
04073-5846
US

IV. Provider business mailing address

27 INDUSTRIAL AVE STE 101
SANFORD ME
04073-5846
US

V. Phone/Fax

Practice location:
  • Phone: 207-459-1666
  • Fax: 207-661-8537
Mailing address:
  • Phone: 207-459-1666
  • Fax: 207-661-8537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number25075
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberMD25646
License Number StateME
# 3
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number25IA12858400
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number25075
License Number StateNH
# 5
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number25IA12858400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: