Provider Demographics
NPI:1235393430
Name:WESTERN MAINE OSTEOPATHIC HEALTHCARE
Entity Type:Organization
Organization Name:WESTERN MAINE OSTEOPATHIC HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:207-778-6999
Mailing Address - Street 1:225 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04938-1910
Mailing Address - Country:US
Mailing Address - Phone:207-778-6999
Mailing Address - Fax:207-778-6980
Practice Address - Street 1:225 MAIN ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04938-1910
Practice Address - Country:US
Practice Address - Phone:207-778-6999
Practice Address - Fax:207-778-6980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1746204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEME0572Medicare PIN