MEDICARE: DR. LISA A RUTSTEIN 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	208600000X	Surgery Physician	MD15538	ME

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00027272	OTHER	ME	RR MEDICARE

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497731269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA A RUTSTEIN MD

Provider Business Mailing Address
First Line	:	16 HOSPITAL DR BLDG SUITEA
Second Line	:
City	:	YORK
State	:	ME
Zip	:	03909-1011
Country	:	US
Telephone Number	:	207-361-3633
Fax Number	:	207-361-3634

Provider Business Practice Location Address
First Line	:	12 HIGH ST STE 205
Second Line	:
City	:	LEWISTON
State	:	ME
Zip	:	04240-7689
Country	:	US
Telephone Number	:	207-795-2935
Fax Number	:	207-795-2319

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

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	10/07/2025

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