NPI 1710297494

Mainehealth

Organisation Urology Physician South Portland, ME

Practice location

Address: 100 Brickhill Ave, South Portland, ME 04106
Phone: (207) 773-1728
Fax: (207) 772-4062
Mailing address: 22 Bramhall St, Portland, ME 04102-3134

Authorised official

Name: Lugene Anthony Inzana
Title: Associate Cfo
Phone: (207) 662-3538

Registered specialties (4)

Urology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208800000X

Other Urology providers in Maine →

General Acute Care Hospital

Hospitals Taxonomy 282N00000X Licence 37563 (ME)

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Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X

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Family Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363LF0000X

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Registry record

NPI: 1710297494
Entity type: Organization
NPI issued: 15 Oct 2010
Record last updated: 19 Dec 2022

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.