Healthcare Provider Details

I. General information

NPI: 1093774119
Provider Name (Legal Business Name): DOUGLAS C AIKEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2006
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 IDEXX DR
WESTBROOK ME
04092-2040
US

IV. Provider business mailing address

100 GANNETT DRIVE STE C
SOUTH PORTLAND ME
04106
US

V. Phone/Fax

Practice location:
  • Phone: 207-556-6802
  • Fax:
Mailing address:
  • Phone: 207-347-2947
  • Fax: 207-874-2317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number010925
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: