Provider Demographics
NPI:1346712536
Name:ADDICTION SPECIALISTS, PC
Entity Type:Organization
Organization Name:ADDICTION SPECIALISTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:FEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:207-395-5445
Mailing Address - Street 1:2540 US ROUTE 202
Mailing Address - Street 2:
Mailing Address - City:WINTHROP
Mailing Address - State:ME
Mailing Address - Zip Code:04364-3072
Mailing Address - Country:US
Mailing Address - Phone:207-395-5445
Mailing Address - Fax:207-395-5526
Practice Address - Street 1:2540 US ROUTE 202
Practice Address - Street 2:
Practice Address - City:WINTHROP
Practice Address - State:ME
Practice Address - Zip Code:04364-3072
Practice Address - Country:US
Practice Address - Phone:207-395-5445
Practice Address - Fax:207-395-5526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-28
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1134188485Medicaid