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General NPI Number Information
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NPI Number | 1053581058
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Entity Type | Individual
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Provider Name | FREDERICK CRAIG LITTLEJOHN M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/05/2008
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Last Update Date | 05/03/2022
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Provider Practice Location Address
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Address Line | 1945 CONGRESS ST STE 103
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City | PORTLAND
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State | ME
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Zip | 04102-1967
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Country | US
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Telephone | 207-835-8116
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Fax |
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Provider Business Mailing Address
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Address Line | 25 CHESTNUT LN
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City | YARMOUTH
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State | ME
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Zip | 04096-8442
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Country | US
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Telephone | 207-835-8116
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 240775
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | EL111002
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License Number State | ME
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