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General NPI Number Information
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NPI Number | 1336482538
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Entity Type | Individual
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Provider Name | CARLA M CANEPA MD
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Gender | Female
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Dates
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Enumeration Date | 04/05/2013
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Last Update Date | 05/14/2020
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Provider Practice Location Address
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Address Line | MMP ADULT HOSPITAL MEDICINE 22 BRAMHALL ST. P2A ROOM 2227
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City | PORTLAND
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State | ME
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Zip | 04102-3175
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Country | US
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Telephone | 207-662-4618
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Fax |
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Provider Business Mailing Address
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Address Line | MMP ADULT HOSPITAL MEDICINE 22 BRAMHALL ST. P2A ROOM 2227
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City | PORTLAND
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State | ME
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Zip | 04102-3175
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Country | US
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Telephone |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD23604
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License Number State | ME
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 284221
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License Number State | NY
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