Healthcare Provider Details

I. General information

NPI: 1992495204
Provider Name (Legal Business Name): CELINE ANGELICA MAGADAN GARCIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2023
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date: 12/18/2023
Reactivation Date: 01/03/2024

III. Provider practice location address

46 FAIRVIEW AVE
SKOWHEGAN ME
04976-1481
US

IV. Provider business mailing address

PO BOX 468
SKOWHEGAN ME
04976-0468
US

V. Phone/Fax

Practice location:
  • Phone: 207-474-5121
  • Fax:
Mailing address:
  • Phone: 207-858-8358
  • Fax: 207-474-9261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD30238
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: