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General NPI Number Information
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NPI Number | 1487346722
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Entity Type | Organization
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Legal Business Name | MAINEHEALTH
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Dates
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Enumeration Date | 05/24/2023
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 110 FREE ST
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City | PORTLAND
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State | ME
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Zip | 04101-3908
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Country | US
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Telephone | 207-661-7001
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 360489
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City | PITTSBURGH
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State | PA
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Zip | 15251-6489
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Country | US
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Telephone | 207-887-5100
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Fax |
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Authorized Official
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Title or Position | ASSOCIATE CFO
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Name | MR. LUGENE A INZANA
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Credential |
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Telephone | 207-661-1346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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