MEDICARE: DR. GARY M HOCHHEISER 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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	226965	MA

General Provider Information

NPI Number	:	1689678112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY M HOCHHEISER MD

Provider Business Mailing Address
First Line	:	190 RIVERSIDE ST
Second Line	:	SUITE 6B
City	:	PORTLAND
State	:	ME
Zip	:	04103-1073
Country	:	US
Telephone Number	:	207-661-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 CAMPUS DR
Second Line	:	SUITE 121
City	:	SCARBOROUGH
State	:	ME
Zip	:	04074-7171
Country	:	US
Telephone Number	:	207-396-7700
Fax Number	:

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

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	04/26/2017

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