Provider Demographics
NPI:1043267396
Name:ARGUEDAS - BROLLO, MIGUEL R (MD)
Entity Type:Individual
Prefix:
First Name:MIGUEL
Middle Name:R
Last Name:ARGUEDAS - BROLLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:121 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 3400
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2653
Mailing Address - Country:US
Mailing Address - Phone:207-406-7300
Mailing Address - Fax:207-406-7301
Practice Address - Street 1:121 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 3400
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2653
Practice Address - Country:US
Practice Address - Phone:207-406-7300
Practice Address - Fax:207-406-7301
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL19281207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME3357401Medicare PIN
AL000008013Medicaid
LA1593681OtherEMERGENCY LA MEDICAID
AL203204949OtherUNITED HEALTHCARE
AL051540764OtherBCBS
AL203204949OtherWORKERS COMP
AL009910853Medicaid
AL051559226OtherMEDICARE
AL110189366OtherRAILROAD MEDICARE
AL051008013OtherBLUE CROSS
ALP00410439OtherRAILROAD ROAD MEDICARE
ALG91813OtherVIVA
ALG91813OtherVIVA