Healthcare Provider Details

I. General information

NPI: 1255727814
Provider Name (Legal Business Name): CHRISTOPHER JAMES LONEGAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2015
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 COMMONS AVE STE A
WINDHAM ME
04062-5554
US

IV. Provider business mailing address

33 SEWALL ST
PORTLAND ME
04102-2638
US

V. Phone/Fax

Practice location:
  • Phone: 207-828-2100
  • Fax: 207-553-7166
Mailing address:
  • Phone: 207-828-2100
  • Fax: 207-553-7166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberDO2877
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: