MEDICARE: PAUL E SEGAL D.O.

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	207RN0300X	Nephrology Physician	DO2850	ME
2	207R00000X	Internal Medicine Physician	DO2850	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619975810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL E SEGAL D.O.

Provider Business Mailing Address
First Line	:	1 MEDICAL CENTER DR
Second Line	:
City	:	BIDDEFORD
State	:	ME
Zip	:	04005-9422
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 LIVEWELL DR
Second Line	:
City	:	KENNEBUNK
State	:	ME
Zip	:	04043-6762
Country	:	US
Telephone Number	:	207-467-8988
Fax Number	:

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

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	05/27/2020

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Directions to “ PAUL E SEGAL D.O.” Practice Location

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