MEDICARE: FAYE M MAIER CST

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	246ZS0410X	Surgical Technologist	081380	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	081380	OTHER	ME	CST

General Provider Information

NPI Number	:	1902956626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FAYE M MAIER CST

Provider Business Mailing Address
First Line	:	24 NEWTON ST
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04103-1524
Country	:	US
Telephone Number	:	207-712-1794
Fax Number	:

Provider Business Practice Location Address
First Line	:	24 NEWTON ST
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04103-1524
Country	:	US
Telephone Number	:	207-712-1794
Fax Number	:

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

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	07/08/2007

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