Healthcare Provider Details

I. General information

NPI: 1780494880
Provider Name (Legal Business Name): ORTHOPAEDIC ASSOCIATES OF MAINE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2025
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
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
04102-2603
US

V. Phone/Fax

Practice location:
  • Phone: 207-828-2100
  • Fax: 207-553-7166
Mailing address:
  • Phone: 207-828-2101
  • Fax: 207-553-7166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: KATHRYN H HANNA
Title or Position: VICE PRESIDENT
Credential: MD
Phone: 207-828-2100