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General NPI Number Information
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NPI Number | 1831016153
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Entity Type | Organization
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Legal Business Name | INTERMED, PA
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Dates
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Enumeration Date | 06/30/2026
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Last Update Date | 06/30/2026
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Provider Practice Location Address
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Address Line | 277 SCARBOROUGH DOWNS ROAD
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City | SCARBOROUGH
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State | ME
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Zip | 04074
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Country | US
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Telephone | 207-347-2947
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Fax |
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Provider Business Mailing Address
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Address Line | 100 GANNETT DR SUITE C
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106
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Country | US
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Telephone | 207-347-2947
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | ROGER POITRAS
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Credential |
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Telephone | 207-347-2947
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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