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NPI Code Detail

MEDICARE: JAMES E SLEEK CC/A

MEDICARE: JAMES E SLEEK CC/A
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1231H00000XAudiologistAP418ME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1027853OTHERMEANTHEM

General Provider Information

NPI Number : 1083603237
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES E SLEEK CC/A
Provider Business Mailing Address
First Line : 1250 FOREST AVE
Second Line : SUITE 301
City : PORTLAND
State : ME
Zip : 04103-1884
Country : US
Telephone Number : 207-797-5753
Fax Number : 207-878-1715
Provider Business Practice Location Address
First Line : 1250 FOREST AVE
Second Line : SUITE 301
City : PORTLAND
State : ME
Zip : 04103-1884
Country : US
Telephone Number : 207-797-5753
Fax Number : 207-878-1715
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2005
Last Update Date : 07/08/2007

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