Provider Demographics
NPI:1396848297
Name:MEDOMAK FAMILY MEDICINE LLC
Entity Type:Organization
Organization Name:MEDOMAK FAMILY MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:H
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:207-832-5813
Mailing Address - Street 1:PO BOX 309
Mailing Address - Street 2:
Mailing Address - City:WALDOBORO
Mailing Address - State:ME
Mailing Address - Zip Code:04572-0309
Mailing Address - Country:US
Mailing Address - Phone:207-832-5813
Mailing Address - Fax:207-832-3070
Practice Address - Street 1:1034 MAIN ST
Practice Address - Street 2:
Practice Address - City:WALDOBORO
Practice Address - State:ME
Practice Address - Zip Code:04572-6037
Practice Address - Country:US
Practice Address - Phone:207-832-5813
Practice Address - Fax:207-832-3070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1104827120OtherWALTER LOVE MD IND NPI #
MEMM3296OtherDR. WEBB IND MEDICARE #
ME$$$$$$$$$OtherDR LOVE SOCIAL SECURITY #
MEMM3303OtherDR LOVE IND MEDICARE #
ME$$$$$$$$$OtherDR WEBB SOCIAL SECURITY #
MEE56949OtherDR WEBB UPIN #
MEE56950OtherDR LOVE UPIN #
E56949OtherDR. WEBB UPIN
ME1972503761OtherMARGARET WEBB MD IND NPI
E56949OtherDR. WEBB UPIN
E56949OtherDR. WEBB UPIN