Provider Demographics
NPI:1447205026
Name:PARKER, HOWARD G (MD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:G
Last Name:PARKER
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 1:324 GANNETT DRIVE SUITE 200
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106
Mailing Address - Country:US
Mailing Address - Phone:207-482-7800
Mailing Address - Fax:207-482-7898
Practice Address - Street 1:690 MINOT AVE
Practice Address - Street 2:SUITE ONE
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-3922
Practice Address - Country:US
Practice Address - Phone:207-783-1328
Practice Address - Fax:207-795-0260
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2017-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2739402207X00000X
MEMD8493207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME116640000OtherCMO MAINECARE PROVIDER NUMBER
ME130600099OtherMAINECARE
AA142370OtherHARVARD PILGRIM
10398601OtherMEDICARE PTAN
MM0716OtherCMO MEDICARE PROVIDER NUMBER
FL34085ZMedicare ID - Type Unspecified
ME130600099OtherMAINECARE