Provider Demographics
NPI:1255488243
Name:REDMOND, STEPHEN M (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:M
Last Name:REDMOND
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:269A US ROUTE ONE
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND FORESIDE
Mailing Address - State:ME
Mailing Address - Zip Code:04110-1329
Mailing Address - Country:US
Mailing Address - Phone:207-829-1200
Mailing Address - Fax:207-829-1201
Practice Address - Street 1:269A US ROUTE ONE
Practice Address - Street 2:
Practice Address - City:CUMBERLAND FORESIDE
Practice Address - State:ME
Practice Address - Zip Code:04110-1329
Practice Address - Country:US
Practice Address - Phone:207-829-1200
Practice Address - Fax:207-829-1201
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1335111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME044353OtherBLUE CROSS PROVIDER ID
MEU92873Medicare UPIN
MERRMM9713Medicare ID - Type Unspecified