NPI 1245871110

Passport Health Holdings, LLC

Organisation Public Health & General Preventive Medicine Physician Portland, ME

Practice location

Address: 22 Monument Square Suite 507, Portland, ME 04101-4031
Phone: (877) 358-8648
Fax: (877) 877-6875
Mailing address: 8324 E Hartford Drive Suite 200, Scottsdale, AZ 85255-7801

Authorised official

Name: Dough Shackell
Title: Director of Finance
Phone: (480) 646-9024

Registered specialties

Public Health & General Preventive Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2083P0901X

Other Preventive Medicine providers in Maine →

Registry record

NPI: 1245871110
Entity type: Organization
NPI issued: 2 Oct 2019
Record last updated: 2 Oct 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.