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NPI Code Detail

MEDICARE: JOSEPH T DEGRINNEY III M.D.

MEDICARE:   JOSEPH T DEGRINNEY III M.D.
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
1208M00000XHospitalist PhysicianMD14646ME
2207R00000XInternal Medicine PhysicianMD14646ME

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00063834OTHERMERAILROAD MEDICARE

General Provider Information

NPI Number : 1538106679
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH T DEGRINNEY III M.D.
Provider Business Mailing Address
First Line : 301 US ROUTE 1
Second Line : BUILDING C
City : SCARBOROUGH
State : ME
Zip : 04074-7609
Country : US
Telephone Number : 207-396-8600
Fax Number : 207-396-8632
Provider Business Practice Location Address
First Line : 300 PROFESSIONAL DR
Second Line :
City : SCARBOROUGH
State : ME
Zip : 04074-8897
Country : US
Telephone Number : 207-883-3491
Fax Number : 207-885-5587
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2006
Last Update Date : 04/12/2020

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