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General NPI Number Information
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NPI Number | 1891907978
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Entity Type | Organization
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Legal Business Name | CENTRAL MAINE ENDOCRINOLOGY
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/07/2008
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Provider Practice Location Address
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Address Line | 287 MAIN ST SUITE 301
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City | LEWISTON
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State | ME
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Zip | 04240-7054
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Country | US
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Telephone | 207-795-9520
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Fax |
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Provider Business Mailing Address
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Address Line | 287 MAIN ST SUITE 301
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City | LEWISTON
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State | ME
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Zip | 04240-7054
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Country | US
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Telephone | 207-795-9520
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Fax |
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Authorized Official
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Title or Position | ENDOCRINOLOGIST
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Name | DR. MAYLENE PERALTA
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Credential | MD
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Telephone | 207-795-7520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 016051
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License Number State | ME
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