=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861515330
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOHN TAYLOR BIELECKI MD, MPH
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/09/2007
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 30 CHASE AVE
-----------------------------------------------------
City | WATERVILLE
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04901-4624
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-872-4260
-----------------------------------------------------
Fax | 207-872-4034
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 39 PINEWOOD DR
-----------------------------------------------------
City | BELGRADE
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04917-3500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-495-2302
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 202C00000X
-----------------------------------------------------
Taxonomy Name | Independent Medical Examiner Physician
-----------------------------------------------------
License Number | 11495
-----------------------------------------------------
License Number State | ME
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2083P0500X
-----------------------------------------------------
Taxonomy Name | Preventive Medicine/Occupational Environmental Medicine Physician
-----------------------------------------------------
License Number | 11495
-----------------------------------------------------
License Number State | ME
-----------------------------------------------------