MEDICARE: LEONID I TEMKIN 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	207LP2900X	Pain Medicine (Anesthesiology) Physician	MD13927	ME

General Provider Information

NPI Number	:	1801881362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEONID I TEMKIN MD

Provider Business Mailing Address
First Line	:	1 MEDICAL CENTER DR
Second Line	:
City	:	BIDDEFORD
State	:	ME
Zip	:	04005-9422
Country	:	US
Telephone Number	:	207-283-7000
Fax Number	:	207-490-7038

Provider Business Practice Location Address
First Line	:	25A JUNE ST
Second Line	:
City	:	SANFORD
State	:	ME
Zip	:	04073-2642
Country	:	US
Telephone Number	:	207-490-7822
Fax Number	:	207-490-7038

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

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	04/02/2014

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