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NPI Code Detail

MEDICARE: TIFFANY P SEGRE MD

MEDICARE: TIFFANY P SEGRE 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
1207Q00000XFamily Medicine PhysicianMD17198ME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437227378
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY P SEGRE MD
Provider Business Mailing Address
First Line : 272 CONGRESS ST
Second Line :
City : PORTLAND
State : ME
Zip : 04101-3637
Country : US
Telephone Number : 207-874-2466
Fax Number : 207-774-4625
Provider Business Practice Location Address
First Line : 272 CONGRESS ST
Second Line :
City : PORTLAND
State : ME
Zip : 04101-3637
Country : US
Telephone Number : 207-874-2466
Fax Number : 207-774-4625
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2006
Last Update Date : 02/11/2026

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