=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023219557
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CENTRAL MAINE PULMONARY ASSOCIATES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/31/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2 GREAT FALLS PLZ SUITE 3B
-----------------------------------------------------
City | AUBURN
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04210-5966
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-784-5489
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2 GREAT FALLS PLZ SUITE 3B
-----------------------------------------------------
City | AUBURN
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04210-5966
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PATIENT ACCOUNTS
-----------------------------------------------------
Name | MS. CATHERINE L BOWIE
-----------------------------------------------------
Credential | CPC
-----------------------------------------------------
Telephone | 207-784-5489
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 012044
-----------------------------------------------------
License Number State | ME
-----------------------------------------------------