Provider Demographics
NPI:1376573550
Name:SEACOAST CARDIOLOGY ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:SEACOAST CARDIOLOGY ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:WANDLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-363-6136
Mailing Address - Street 1:12 HOSPITAL DR
Mailing Address - Street 2:SUITE 9
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-1030
Mailing Address - Country:US
Mailing Address - Phone:207-363-6136
Mailing Address - Fax:207-363-4863
Practice Address - Street 1:12 HOSPITAL DR
Practice Address - Street 2:SUITE 9
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909-1030
Practice Address - Country:US
Practice Address - Phone:207-363-6136
Practice Address - Fax:207-363-4863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30002427Medicaid
NHRE0977Medicare PIN
NH30002427Medicaid