Provider Demographics
NPI:1477524387
Name:DALGLISH, PRESTON H JR (MD)
Entity Type:Individual
Prefix:
First Name:PRESTON
Middle Name:H
Last Name:DALGLISH
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:100 CAMPUS DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-9692
Mailing Address - Country:US
Mailing Address - Phone:207-885-8394
Mailing Address - Fax:207-282-7610
Practice Address - Street 1:26 W COLE RD
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-9407
Practice Address - Country:US
Practice Address - Phone:207-282-1148
Practice Address - Fax:207-286-9126
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2017-08-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME12061207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0119203OtherCIGNA
ME0119203OtherCIGNA
ME017283OtherANTHEM BCBS
ME123590099Medicaid
NC1477524387Medicaid
NCP01850778OtherRR MEDIARE
ME2041781OtherAETNA HMO
NH30203358Medicaid
ME5349698OtherAETNA
NC0119203OtherCIGNA
E03524Medicare UPIN
NC1477524387Medicaid