Provider Demographics
NPI:1417043712
Name:WINCHENBACH, CURTIS LORING (MD)
Entity Type:Individual
Prefix:
First Name:CURTIS
Middle Name:LORING
Last Name:WINCHENBACH
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 1:131 CHADWICK ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-3214
Mailing Address - Country:US
Mailing Address - Phone:207-773-7078
Mailing Address - Fax:207-774-3463
Practice Address - Street 1:131 CHADWICK ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-3214
Practice Address - Country:US
Practice Address - Phone:207-773-7078
Practice Address - Fax:207-774-3463
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME011056207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME002505OtherANTHEM PROVIDER NUMBER
MEB86539Medicare UPIN
ME002505OtherANTHEM PROVIDER NUMBER