Provider Demographics
NPI:1346222619
Name:RAYMOND, GUY GEORGE (MD)
Entity Type:Individual
Prefix:
First Name:GUY
Middle Name:GEORGE
Last Name:RAYMOND
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 1:194 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FORT KENT
Mailing Address - State:ME
Mailing Address - Zip Code:04743-9977
Mailing Address - Country:US
Mailing Address - Phone:207-834-3155
Mailing Address - Fax:807-834-5388
Practice Address - Street 1:194 E MAIN ST
Practice Address - Street 2:
Practice Address - City:FORT KENT
Practice Address - State:ME
Practice Address - Zip Code:04743-9977
Practice Address - Country:US
Practice Address - Phone:207-834-3155
Practice Address - Fax:807-834-5388
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME010266207P00000X
MEMD10266207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B86775Medicare UPIN