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General NPI Number Information
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NPI Number | 1154340305
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Entity Type | Organization
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Legal Business Name | MILLENNIUM ANESTHESIA PC
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 01/21/2008
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Provider Practice Location Address
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Address Line | 100 TER HEUN DR
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City | FALMOUTH
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State | MA
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Zip | 02541
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Country | US
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Telephone | 508-457-3580
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 676
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City | LEWISTON
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State | ME
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Zip | 04243-0676
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Country | US
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Telephone | 800-720-1664
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Fax | 207-753-2020
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MARK KAMP
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Credential | MD
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Telephone | 508-457-3580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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