Healthcare Provider Details

I. General information

NPI: 1760820385
Provider Name (Legal Business Name): JOHN RICHARD OGOREK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2013
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PROFESSIONAL DR STE 2B
SCARBOROUGH ME
04074-8897
US

IV. Provider business mailing address

300 PROFESSIONAL DR STE 2B
SCARBOROUGH ME
04074-8897
US

V. Phone/Fax

Practice location:
  • Phone: 207-761-1502
  • Fax: 207-774-2015
Mailing address:
  • Phone: 207-761-1502
  • Fax: 207-774-2015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD23687
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberMD23687
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: