Healthcare Provider Details

I. General information

NPI: 1497972723
Provider Name (Legal Business Name): EDMUND HAMILTON SEARS JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 FODEN RD WEST BUILDING, SUITE 103
SOUTH PORTLAND ME
04106-2327
US

IV. Provider business mailing address

100 FODEN RD WEST BUILDING, SUITE 103
SOUTH PORTLAND ME
04106-2327
US

V. Phone/Fax

Practice location:
  • Phone: 207-828-1122
  • Fax: 207-828-0188
Mailing address:
  • Phone: 207-828-1122
  • Fax: 207-828-0188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD12749
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD19222
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMD19222
License Number StateME
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD12749
License Number StateRI
# 5
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD12749
License Number StateRI
# 6
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD19222
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: