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General NPI Number Information
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NPI Number | 1902092828
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Entity Type | Organization
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Legal Business Name | GENERATIONS FAMILY MEDICINE, LLC
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Dates
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Enumeration Date | 09/25/2007
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Last Update Date | 10/18/2009
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Provider Practice Location Address
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Address Line | 6 MIDDLE ST
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City | AUGUSTA
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State | ME
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Zip | 04330-5211
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Country | US
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Telephone | 207-621-2700
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Fax | 207-621-2755
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Provider Business Mailing Address
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Address Line | 6 MIDDLE STREET
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City | AUGUSTA
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State | ME
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Zip | 04330
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Country | US
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Telephone | 207-621-2700
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Fax | 207-621-2755
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHELLE P PERKINS
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Credential | M.D.
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Telephone | 207-621-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 015013
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License Number State | ME
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