MEDICARE: DR. MICHAEL F REGAN 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
1	207X00000X	Orthopaedic Surgery Physician	013994	ME

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
4	MM0716	OTHER	MEDICARE CLINIC FACILITY
6	201017	OTHER	MEDICARE ASC FACILITY
7	DX7121	OTHER	NEW MEDICARE PTAN
8	200029713	OTHER	RR MEDICARE
11	MM6003	OTHER	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0378600001	OTHER		DMERC
2	277270099	OTHER	ME	MAINECARE
3	025025	OTHER		ANTHEM
5	100294000	OTHER		USPS WC
9	M90691	OTHER		CIGNA
10	010416156	OTHER		TRAVELERS/CORE/MEDNET
12	MNT181	OTHER		HARVARD

General Provider Information

NPI Number	:	1790780922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL F REGAN M.D.

Provider Business Mailing Address
First Line	:	690 MINOT AVE
Second Line	:	STE 1
City	:	AUBURN
State	:	ME
Zip	:	04210-3922
Country	:	US
Telephone Number	:	207-783-1328
Fax Number	:	207-795-0260

Provider Business Practice Location Address
First Line	:	690 MINOT AVE
Second Line	:	STE 1
City	:	AUBURN
State	:	ME
Zip	:	04210-3922
Country	:	US
Telephone Number	:	207-783-1328
Fax Number	:	207-795-0260

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

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	09/19/2012

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Directions to “ DR. MICHAEL F REGAN M.D.” Practice Location

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