MEDICARE: DR. PETER R HARBAGE MD

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
1	207R00000X	Internal Medicine Physician	MD11984	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124008784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER R HARBAGE MD

Provider Business Mailing Address
First Line	:	193 MAIN ST
Second Line	:	SUITE 1
City	:	NORWAY
State	:	ME
Zip	:	04268-5645
Country	:	US
Telephone Number	:	207-743-7721
Fax Number	:	207-743-6306

Provider Business Practice Location Address
First Line	:	193 MAIN ST
Second Line	:	SUITE 1
City	:	NORWAY
State	:	ME
Zip	:	04268-5645
Country	:	US
Telephone Number	:	207-743-7721
Fax Number	:	207-743-6306

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	09/26/2012

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