Provider Demographics
NPI:1154473585
Name:ALAMO, AQUILINO (MD)
Entity Type:Individual
Prefix:
First Name:AQUILINO
Middle Name:
Last Name:ALAMO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 745
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:ME
Mailing Address - Zip Code:04553-0745
Mailing Address - Country:US
Mailing Address - Phone:207-563-4146
Mailing Address - Fax:207-563-4103
Practice Address - Street 1:19 SAINT ANDREWS LN
Practice Address - Street 2:
Practice Address - City:BOOTHBAY HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04538-1732
Practice Address - Country:US
Practice Address - Phone:207-633-7820
Practice Address - Fax:207-563-4103
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME014696207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME298680099Medicaid
ME298680099Medicaid
MEP00074945Medicare PIN
MEMM7425Medicare PIN