Provider Demographics
NPI:1225191596
Name:SEACOAST MEDICAL CARE PA
Entity Type:Organization
Organization Name:SEACOAST MEDICAL CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WOODROW
Authorized Official - Middle Name:D
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:207-286-3504
Mailing Address - Street 1:57 BARRA RD
Mailing Address - Street 2:SUITE #1
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-9448
Mailing Address - Country:US
Mailing Address - Phone:207-286-3504
Mailing Address - Fax:207-286-3767
Practice Address - Street 1:57 BARRA RD
Practice Address - Street 2:SUITE #1
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-9448
Practice Address - Country:US
Practice Address - Phone:207-286-3504
Practice Address - Fax:207-286-3767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty