Healthcare Provider Details

I. General information

NPI: 1902369598
Provider Name (Legal Business Name): NATALIE ESTHER STEC MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2019
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date: 11/27/2019
Reactivation Date: 07/20/2020

III. Provider practice location address

265 WESTERN AVE STE 2
SOUTH PORTLAND ME
04106-2458
US

IV. Provider business mailing address

265 WESTERN AVE STE 2
SOUTH PORTLAND ME
04106-2458
US

V. Phone/Fax

Practice location:
  • Phone: 207-661-0200
  • Fax: 207-661-0299
Mailing address:
  • Phone: 207-661-0200
  • Fax: 207-661-0299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number4351044603
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD28759
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: